Winnipeg-based insurance giant Great-West Life Assurance Co. (GWL) has been hit with a lawsuit from a policyholder alleging that the firm breached a duty of care owed to the policyholder after denying him critical illness (CI) coverage.
Alfredo D’Agui of Winnipeg is seeking $100,000 from GWL, the same amount as the value of the CI policy he took out two years ago. His agent, Grant Page, and Page’s company, Financial Heights Inc. of Winnipeg, are also named in the lawsuit.
None of the allegations in the statement of claim filed on May 15 has been proven in court. A spokeswoman for GWL says the insurance firm does not comment on matters before the courts. Efforts to contact Page were unsuccessful. A statement of defence has not yet been filed.
According to the statement of claim, D’Agui went to Page’s office to apply for the CI policy in June 2013. In response to the questionnaire required on the application, D’Agui alleges that he informed Page that he had Type II Diabetes, but did not require insulin. D’Agui said he was a “borderline diabetic” and was taking medication for the condition, according to the claim.
D’Agui alleges that Page failed to record several of his answers relating to his condition accurately. Upon completion of the questionnaire, D’Agui further alleges that Page told him he was unsure whether his application would be approved. Before the end of the month, however, D’Agui says he was informed that his application had indeed gone through.
Sixteen months later, D’Agui, who owns and operates a hairdressing salon, suffered a heart attack. When he applied for CI benefits, GWL informed D’Agui that his CI policy was null and void due to a “material misrepresentation” of not indicating to the company that he suffered from diabetes and had undergone blood tests within the past five years.
GWL subsequently returned the premiums D’Agui had paid. He had been paying $250 per month.
D’Agui, 50, says he and Page have known each other since their school days, which increased his level of trust. In the statement of claim, he alleges that he and Page had a fiduciary relationship and that he “put complete trust in Page’s ability to exercise all due care and skill in preparing and arranging for insurance coverage.”
D’Agui says he has since recovered well from his heart attack but was forced to take seven weeks away from his salon: “I’m lucky I didn’t lose my livelihood. I was waiting for this [insurance] payout to help. I almost went bankrupt. I’ve been working like crazy ever since.”
Dave Hill, the lawyer representing D’Agui, says his case is very similar to another one involving GWL from a couple of years ago. In that case, GWL was found responsible for the actions of a former rogue broker, Gary Palmer. “It involves the role of an agent; that’s the significance of the case,” Hill says.
Whether or not the actions of Page and GWL could be separated from each other, Hill says that clients can’t tell the difference between the two.
“An innocent third party only sees a company through the role of the agent. They’re the only people they deal with,” Hill says.