SINGAPORE: A woman has lost her suit seeking over S$108,000 (US$78,345) for brain aneurysm surgery from insurer Prudential Assurance Company Singapore, with the judge saying it is unfair to say Prudential had hidden a clause.
Ms Cai Yunhong, 45, had alleged that Prudential had denied her claim because of a “single, buried clause” defining brain aneurysm surgery as only the open-skull procedure of surgical craniotomy, a procedure she said was riskier and more invasive, with higher mortality rates.
However, in a written judgment on Thursday (Sep 3), a district court dismissed her claim, saying that the characterisation of the clause being hidden or buried in the policy document was “not a fair one”.
District Judge Teo Guan Kee said that on an objective view of the policy, there was no room for doubt about the coverage afforded and how coverage would not be engaged if an insured person underwent endovascular repair or procedures, as Ms Cai did.
WHAT HAPPENED
Ms Cai had suffered a stroke from a ruptured aneurysm in 2023 and collapsed while taking a bus. She was taken to hospital, with an emergency operation being performed by the head of neurosurgery at the National University Hospital.
She spent 21 days in hospital, including eight days in the intensive care unit but recovered “miraculously well”.
Ms Cai claimed that she was not given a choice as to what type of surgery would be performed, and discovered only later that Prudential’s policy made payouts only in instances where a brain aneurysm is treated via a surgical craniotomy – a procedure where part of the skull is removed to reach the brain.
She had undergone endovascular repair instead, which she said was the modern, minimally invasive and evidence-based first-line treatment for her condition.
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