Prudential Insurance Claim Rejected: How to Appeal Prudential Decisions

Prudential Insurance Claim Rejected: How to Appeal Prudential Decisions

Prudential is one of the world's largest insurance groups, operating across Asia, the UK, and the US. In Asia, Prudential is a dominant player in life, health, and savings insurance. If Prudential has rejected your insurance claim, you have clear appeal rights under the regulatory framework of your market. This guide covers the Prudential appeal process in Singapore, Malaysia, the United Kingdom, and Hong Kong.

About Prudential's Asian and UK Operations

Prudential's primary Asian operations are conducted under Prudential plc (listed in London and Hong Kong) and its subsidiary Eastspring Investments, while its Asian life insurance business operates under the Prudential brand across multiple markets.

Key Prudential entities:

• Prudential Singapore: Prudential Assurance Company Singapore Pte Ltd, regulated by MAS
• Prudential Malaysia: Prudential BSN Takaful Berhad (takaful) and Prudential Assurance Malaysia Berhad, regulated by BNM
• Prudential UK: Prudential Regulation Authority (PRA) and FCA regulated
• Prudential Hong Kong: Prudential Hong Kong Limited, regulated by the Insurance Authority

Common Prudential Denial Patterns

Non-disclosure / material misrepresentation: Like all major life and health insurers, Prudential routinely investigates large claims for non-disclosure at the application stage. If Prudential's medical underwriting team identifies a health condition that was not declared on the application form, it will seek to deny or void the claim. This is particularly common in:

• Critical illness claims
• Total permanent disability (TPD) claims
• Death claims with pre-existing medical history

Critical illness — clinical definition disputes: Prudential's critical illness products use precise medical definitions. Denials frequently occur when a diagnosed condition does not precisely meet the product's definition — for example, a cancer that is in situ or not of the specified stage, a heart attack that does not meet ECG and enzyme threshold requirements, or a stroke with insufficient documented neurological impairment.

Hospitalisation pre-authorisation issues: Prudential's hospitalisation products require pre-authorisation (a Letter of Guarantee, LOG) for non-emergency hospital admissions. If you or your doctor failed to obtain pre-authorisation, Prudential may deny the hospitalisation claim or reduce the benefit significantly.

TPD occupation/activity tests: For disability income and TPD claims, Prudential applies "own occupation" or "any occupation" tests depending on the policy version. Disputes often arise about whether the insured truly cannot perform their occupation.

Investment-linked policy (ILP) charges and switches: Prudential sells ILPs, and disputes about fund switches, charges, or policy value can arise from misunderstandings about how these products work.

Appealing a Prudential Claim Denial in Singapore

Internal Appeal Process

File your formal appeal in writing to Prudential Singapore's Customer Service department.

Contact:

• Phone: 1800 333 0333
• Website: prudential.com.sg
• Address: Prudential Assurance Company Singapore Pte Ltd, 30 Cecil Street, #28-01 Prudential Tower, Singapore 049712

Under MAS guidelines, Prudential Singapore must:

• Acknowledge complaints within 5 business days
• Issue a final response within 21 working days

Your appeal letter should directly address every denial ground in Prudential's decision letter. For medical disputes, include specialist medical opinions. For non-disclosure disputes, explain the basis on which the condition was not material or was not known to you at the time of application.

Escalation: FIDReC and MAS

If Prudential Singapore does not resolve your complaint satisfactorily:

• FIDReC: fidrec.com.sg — for claim disputes up to SGD 100,000, free mediation and adjudication
• MAS: mas.gov.sg/complaints — for regulatory concerns including mis-selling

Use ClaimBack at claimback.app to generate a professionally structured, MAS-compliant appeal letter for Prudential Singapore disputes.

Appealing a Prudential Claim Denial in Malaysia

Internal Appeal Process

For Prudential Assurance Malaysia Berhad and Prudential BSN Takaful, file your formal complaint with Prudential Malaysia's Customer Service.

Contact:

• Phone: 1800 888 322
• Website: prudential.com.my
• Address: Prudential Assurance Malaysia Berhad, Level 19, Menara Prudential, Persiaran TRX Barat, Tun Razak Exchange, 55188 Kuala Lumpur

Under BNM guidelines, Prudential Malaysia must acknowledge complaints within 5 working days and provide a substantive response within 14 working days.

Escalation: OFS and BNM

• OFS: ofs.org.my — free, handles disputes up to RM 250,000
• BNM BNMTELELINK: 1-300-88-5465 — for regulatory and systemic concerns

Appealing a Prudential Claim Denial in the United Kingdom

Internal Appeal Process

In the UK, Prudential is regulated by the Prudential Regulation Authority (PRA) and the Financial Conduct Authority (FCA). Prudential UK's main insurance business (M&G Prudential, now trading partly as M&G) offers savings, annuities, and protection products.

Contact:

• Website: prudential.co.uk
• Complaints: Available through the Prudential website or by post to their servicing centre

Under FCA rules (DISP), Prudential UK must:

• Acknowledge complaints promptly
• Issue a final response within 8 weeks

Escalation: FOS

If Prudential UK's response is unsatisfactory:

• Financial Ombudsman Service (FOS): financial-ombudsman.org.uk — free for consumers, binding decisions up to £430,000

Appealing a Prudential Claim Denial in Hong Kong

Internal Appeal Process

Prudential Hong Kong Limited is regulated by the Insurance Authority (IA) of Hong Kong.

Contact:

• Phone: (852) 2281 1333
• Website: prudential.com.hk

Escalation: Insurance Authority and ICCB

• Insurance Authority (IA): ia.org.hk — complaints about insurer conduct
• Insurance Claims Complaints Bureau (ICCB): iccb.org.hk — general insurance claims disputes

How to Write an Effective Prudential Appeal Letter

For critical illness / clinical definition disputes:

• Obtain a detailed consultant report from a senior specialist (oncologist, cardiologist, neurologist as applicable) that specifically addresses whether your condition meets the policy's clinical definition
• Cite the latest clinical guidelines from recognised bodies (NICE, Singapore Ministry of Health, Malaysian Health Technology Assessment Section)
• If Prudential's definition is stricter than current clinical consensus, say so explicitly with references

For non-disclosure disputes:

• Identify the specific health condition Prudential says you failed to disclose
• Establish what you knew (or did not know) at the time of application
• If the condition was not diagnosed until after the policy was issued, provide the diagnosis timeline clearly
• Check whether the non-disclosed condition is actually the cause of the claim — if not, the link between the non-disclosure and the denial may be challengeable

For hospitalisation/pre-authorisation disputes:

• Provide evidence that the admission was an emergency (in which case pre-authorisation may not apply)
• Check whether Prudential's pre-authorisation requirement was clearly communicated
• Provide the hospital's assessment of the admission's necessity

Use ClaimBack at claimback.app to generate a structured, market-specific appeal letter for any type of Prudential claim dispute.

Conclusion

Prudential claim rejections are common, particularly for critical illness and non-disclosure-related denials. However, many of these denials are successfully overturned on appeal when policyholders provide strong clinical evidence and well-structured arguments. Follow the correct internal appeal process for your market, escalate to FIDReC, OFS, or FOS as applicable, and use ClaimBack at claimback.app to build the strongest possible foundation for your appeal.