Titular de Insurance Insights
Volume 6, No. 5 - May 2017

Noticias Útiles

- Updating you on what's going on


~For free insurance assistance, Floridians can call 1-877-693-5236~

Antes del inicio de la Temporada de Huracanes del Atlántico 1, el 2017 de junio, el Oficial Principal de Finanzas Jeff Atwater recuerda a los residentes de la Florida que registren en número gratuito de ayuda con seguros del Estado de la Florida: (1-877-693-5236). Operado por el Departamento de Servicios Financieros, la línea de ayuda conecta a los residentes de la Florida directamente con expertos en seguros que pueden ayudarlos a presentar un reclamo de seguro, comprender mejor sus pólizas y establecer contratiempos que pueden surgir durante el proceso de presentación de un reclamo.

“Getting back on your feet following a storm can be a stressful state of affairs, but I hope that having free and ready access to insurance expertise can help the recovery process run more efficiently for Florida families,” said CFO Atwater. “All Floridians should keep the helpline phone number on their emergency contact list and inside their family’s hurricane kit.”

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14 Personas Arrestadas en Miami Luego del Fraude en un Establecimiento de Vida Asistida

Chief Financial Officer Jeff Atwater announced 14 arrests following a year-long investigation led by insurance fraud investigators with the Department of Financial Services. Investigators uncovered an alleged fraud scheme in which an assisted living facility (ALF) in Miami intentionally misrepresented its business activities in an attempt to obtain an inadequate but cheaper insurance policy. When an insurance policy is knowingly secured under false pretenses, the insurance carrier oftentimes reserves the right to deny claims for loss or injury.

Citizens Property Insurance Corporation (Citizens), the company’s insurance carrier, first discovered the fraud following the filing of a claim for a broken pipe in 2014. During the processing of the claim, Citizens suspected that the ALF had intentionally misrepresented its business activities in an attempt to secure a cheaper, residential insurance policy rather than the required commercial policy. Citizens referred their findings to the Department’s Division of Investigative and Forensic Services.

The case ultimately initiated a larger series of investigations that took place between June 2016 and May 2017 which identified a trend of misrepresentation taking place within the ALF industry. The Department, with support from Citizens and the National Insurance Crime Bureau, identified a total of 14 ALF operators in Miami-Dade County who allegedly defrauded their insurance carrier.

Entre los arrestados están:

• Jose Perez - Living Well, 21280 Old Cutler Rd. Miami, Fla. 33189 FL. 33032
• Aida Salguiro - Amor Y Esperanza Home Care, 3224 West 14 Avenue, Hialeah Fla. 33012
• Gilberto Peralta - Angel's Home, 7935 SW 146th CT Miami, Fla. 33183
• Thelma Waite-Blake - B & B Home Care Service, 20625 SW 114th Place Miami, Fla. 33189
• Eduardo Rodriguez - Loving Hands ALF, 2291 SW 100 Ave., Miami, Fla. 33165
• Teresita Leon - Teresita Home Care, Inc., 4840 SW 89Th PL, Miami, Fla. 33165
• Guillermo Jesus Mendez - La Casita Nuestra Home II, 14909 SW 22nd Street, Miami, Fla. 33185
• Barbara Plaza - Cornell ALF, 581-583 Central Blvd, Miami, Fla. 33144
• Jorge Pulido - La Casita Nuestra Home II, 14909 SW 22nd Street, Miami, Fla. 33185
• Leonel Burmudez - Bermudez Senior Care, 5301 SW 162 Place, Miami, Fla. 33185

Additionally, investigators arrested an insurance agent, Alina Fernandez, after she was found to have forged another insurance agent’s name on two fraudulent ALF insurance applications for Jorge Pulido. She was also found to have been acting without the proper license.

Fernandez was transported to Turner Guilford Knight Correctional Facility and was charged with acting as an unlicensed agent, ID fraud, and organized fraud. The Department’s Division of Agent and Agency Services' Bureau of Investigation has revoked her license and banned her from working in the insurance industry.

The remaining 13 subjects arrested were transported to Turner Guilford Knight Correctional Facility and have been charged with one count of application fraud, a third-degree felony. These cases will be prosecuted by the Miami Dade State Attorney’s Office and if convicted, those arrested face up to 5 years in prison.

Los ALF son residencias de cuidados a largo plazo que ofrecen varios servicios, tales como administración de salud y medicina, transporte y servicios de comidas para ayudar a los adultos mayores y los miembros de nuestras comunidades locales que sufren de discapacidades físicas y del desarrollo.

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Insurance Commissioner Altmaier’s Message to Floridians:
Prepare Now for the 2017 Hurricane Season

Florida Insurance Commissioner David Altmaier has an important message for Floridians ahead of the hurricane season beginning on June 1.

“Florida’s unique risk to tropical weather, especially during the hurricane season, means all Floridians need a disaster plan,” said Altmaier. “The time to evaluate your insurance coverage, fortify your home and prepare for how to protect yourself and your family is now.”

Altmaier is also advising Floridians to take advantage of numerous hurricane preparedness resources available to them on the Office of Insurance Regulation’s (Office) website and offers the following additional tips:

  • Review your insurance policy with your insurance agent or insurance company to make sure the coverage is adequate to your individual needs. The “Declarations Page” of your policy will summarize the coverage you have purchased.
  • Understand the differences between your insurance policy’s coverages and deductibles.
  • Strengthen your home’s defenses against a storm through simple mitigation techniques, such as replacing worn weather stripping under doors and removing tree limbs that may fall on your home or become flying projectiles.
  • Inventory your valuables and possessions using a home inventory checklist, which is available as a form you can download and print. If you prefer to use a smartphone, there is a link to a free app created by the National Association of Insurance Commissioners, which allows you to take pictures and add descriptions of your belongings.
  • Know the phone number and contact information for your insurance agent and insurance company. Make sure to have easy access to it if you must evacuate your home.
  • Most importantly, have a plan for what you will do if a storm system is expected to impact where you live. Do not wait to evacuate if it becomes necessary.

For more information, visit the Office’s “Hurricane Season Resources” webpage at: http://www.floir.com/Office/HurricaneSeason/hurricaneresourcepage.aspx.

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Línea de Ayuda al Consumidor de Seguros del Oficial Principal de Finanzas Atwater Recupera $8 Millones para los Residentes de la Florida en el Primer Trimestre de 2017.

Florida’s Chief Financial Officer Jeff Atwater announced that assistance provided to Floridians by insurance specialists working Florida’s insurance consumer helpline led to the recovery of nearly $8.1 million in the first quarter of 2017. Recoveries included insurance claim payments and premium refunds that consumers sought the Department of Financial Services’ help collecting.

The helpline assists Floridians with financial and insurance-related matters including disaster preparation and insurance fraud as well as questions and complaints regarding auto, home, health, life, and small business insurance. Between January 1, 2017 and March 31, 2017, the helpline’s insurance specialists answered 70,634 calls and opened nearly 5,000 assistance requests. More than $8.1 million was recovered on behalf of 866 consumers.

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El Oficial Principal de Finanzas y Jefe de Bomberos del Estado Jeff Atwater Habla Sobre Aspectos Básicos de la Seguridad contra Incendios Durante la Semana de Concientización sobre Incendios Intencionales

Florida’s Chief Financial Officer, who also serves as Florida’s State Fire Marshal, recognized May 7-13 as Arson Awareness Week by reminding Floridians to practice basic fire safety.

“Lives are put needlessly at risk, homes are destroyed and acres of land are ruined by this senseless, preventable crime,” said CFO Atwater. “As wildfires have ravaged parts of Florida, some started by human intervention, now is the time to focus on this costly, detrimental crime and how we can all do more to stop it".

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Los Esfuerzos en la Lucha Contra el Fraude del Oficial Principal de Finanzas Atwater Tuvieron Éxito en el Primer Trimestre de 2017

Florida’s Chief Financial Officer Jeff Atwater announced that fraud-fighting efforts led by the Department of Financial Services took 322 law-breaking fraudsters off the streets during the first quarter of 2017. The Department’s anti-fraud efforts focus on the areas of public assistance and insurance fraud, arson, and the theft or abuse of state funds.

"Los fraudes de cualquier tipo elevan los costos para todos los residentes de la Florida", dijo el Oficial Principal de Finanzas Atwater. "Nuestros esfuerzos son más fuertes gracias a la sociedad que hemos formado con las agencias de policía locales y espero que estos resultados envíen una onda expansiva a otros posibles delincuentes para que piensen dos veces antes de cometer un delito".

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Office Update on Florida Blue’s Payment Processing Issue

The Florida Office of Insurance Regulation (Office) is aware that many Florida Blue customers experienced multiple fund withdrawals from their bank accounts to pay for what should have been a one-time scheduled payment of their May health insurance policy premium. Florida Blue advised this was a processing error by the company’s third-party vendor.

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Make Sure You Don't Miss Important Information From Us

We highly recommend licensees routinely check their Mi Perfil accounts for messages from the Department. We send an email notification when a message has been sent to remind you to check your Mi Perfil account, but on rare occasions you may not receive that email. For this reason, we suggest you add our domains dfs.state.fl.us y MyFloridaCFO.com to your email software's Trusted or Safe Senders List to ensure you are able to receive email notifications from us. Licensees who have a valid email address on file with the Department, as required by law, are sent important email notifications when something affecting their application, license, continuing education, or appointment(s) occurs. Additionally, we will keep you informed with warnings regarding new schemes and scams being marketed to licensees. You can update your contact information through your Mi Perfil account. We want to keep you informed in a timely manner of pertinent information. You are still required to abide by the Florida Insurance Code regardless of whether you read the information we provide or attempt to provide.