Prudential's product designer unaware of excluded treatment; bank consultant deferred on claim outcome

Prudential Assurance Company Singapore's (Prudential) product designer acknowledged he was unaware of an excluded treatment when he joined the company, as two witnesses were cross-examined on 30 April 2026, the final day of hearings before District Judge Teo Guan Kee in the suit brought by stroke survivor Cai Yanhong.

Cai, 45, is seeking a payout of S$108,500 under the PruLife Multiplier policy she purchased from Prudential through SCB in 2016.

Prudential denied her claim in August 2023 following a stroke caused by a ruptured brain aneurysm, on the basis that the endovascular repair she underwent did not meet the policy's definition of covered brain aneurysm surgery, which required surgical craniotomy.

The witnesses examined were Lim Yeong Tah, Prudential's Senior Director of Product Development and Innovation, who continued from the previous hearing, and Tan Kwang Hui, a Director in the Wealth Management and Bancassurance Department at Standard Chartered Bank (Singapore) Limited (SCB), who took the stand later in the day.

Product designer did not know excluded treatment existed

Cai asked Lim whether he had known what endovascular repair was when he joined Prudential in 2021. Lim said he did not. She also asked whether his role required him to be up to date with the latest available treatments. Lim replied: "No."

When Cai asked whether medical specialists were best placed to decide the appropriate treatment for a patient, Lim agreed. He also agreed that neurosurgeons would be best positioned to provide input for treatment for a brain aneurysm.

Lim confirmed that locating the exclusion relevant to Cai's claim required navigating four separate places in the policy document. He said these served "different purposes."

When asked whether he had reviewed the exclusions in the withdrawn product to assess whether they remained relevant while customers continued paying premiums, Lim said he had not. He told the court that once a policy is issued it becomes a long-term contract, and there was no obligation to revise its terms and conditions after the product was withdrawn from sale.

Lim acknowledged that when designing products, Prudential consulted its claims department for input, but could not confirm whether either the product design team or the claims department included any medical professionals. He said only the human resources department would have that information.

SCB consultant could not explain excluded treatment

Tan Kwang Hui, the financial service consultant from SCB who sold the PruLife Multiplier policy to Cai at a meeting on 17 August 2016, took the stand in the afternoon.

Cai asked whether he knew which of the two procedures — craniotomy or endovascular repair — carried the lower morbidity rate. Tan said he did not know.

Cai then asked how he could explain to a customer an exclusion he did not himself understand. Tan said he ran through what was covered in the policy and was not medically trained to know the intricacies of the procedures.

Cai also questioned Tan on his earlier answer that the only exclusions under the policy related to pre-existing conditions. During re-examination by Prudential's counsel Joavan Pereira of Virtus Law, Tan clarified that when he earlier responded to Cai on “exclusions,” he was referring to pre-existing conditions and claims that did not meet the policy's definitions, rather than an assertion that no treatment-based exclusions existed.

Bank consultant declines to say whether claim would be rejected

Cai produced a chain of emails between herself and Tan. Tan confirmed he received an email from Cai on 11 May 2023 disclosing that she had undergone endovascular coiling following her stroke.

When asked whether, given his policy knowledge, he had believed the claim would most likely be rejected, Tan replied: "I do not have a reference on whether I believe it will be not claimable," adding that he had to let the claims department ascertain the outcome.

Cai then asked whether he was not 100 per cent certain the claim would be rejected. Tan replied: "On medical terms, I have to leave it to the claims department."

Cai had requested an authorisation form from Tan so that Prudential could obtain medical documents directly from the National University Hospital (NUH). Cai spent approximately three months gathering medical documentation, completing the process by 29 August 2023. The claim was subsequently rejected by Prudential.

Time spent explaining the policy at point of sale

Cai questioned whether it was realistic for Tan to have explained all relevant documents thoroughly at the 17 August 2016 sales meeting, which he described as lasting two to two and a half hours.

The four documents covered at the meeting were the policy illustration, financial needs analysis, pre-order form, and proposal form, totalling 83 pages. Cai calculated this at approximately 30 seconds per page, based on an assumption that two separate sets of documents had been prepared for her and her husband.

During re-examination, Prudential's counsel raised that as Cai and her husband had purchased identical policies, the policy illustration had been presented to both of them simultaneously. Tan confirmed the financial needs analysis was conducted separately for each, but that the policy illustration was shared. The clarification was not disputed, and Tan maintained he had gone through every page thoroughly.

Tan confirmed that he asked Cai to sign the free-look clause and the first ten pages of the documents, maintaining that he acted according to the requirements of the forms. He confirmed he did not ask her to sign against the exclusion clause.

Cai asked whether financial service consultants generally focused on key benefits such as premiums and coverage amounts, giving less attention to detailed exclusions. Tan said he could not speak for other consultants, but maintained that he had gone through every page of the policy illustration with her.

After cross-examination concluded, the court marked and admitted into evidence the email chain from Cai spanning 10 May to August 2023.

Prudential's position

Prudential has maintained throughout the proceedings that the claim was correctly denied as the procedure Cai underwent did not meet the definition of covered brain aneurysm surgery under the policy.

The insurer has said that in 2016, insurers had different approaches to covering endovascular repair. Some of its newer critical illness policies, including a plan launched in March 2026, now cover the procedure.

The hearing phase of the trial has concluded. Both parties are expected to file written submissions before District Judge Teo Guan Kee delivers judgment.

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Editor's note: The article has been edited to better clarify what transpired in court with inputs from parties.