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Inicio del Departamento | Inicio de Agentes y Agencias | Inicio de Insurance Insights

  Vol. 7 No. 1 January 2018

Notas de Casos

Case: An investigation was opened as a follow up on a suspended agent to determine whether he was complying with the Order of Suspension. The business address listed for the agent in Department records proved to be a vacant office. Through state employment records, investigators determined the suspended agent was in fact, currently employed by an insurance-related entity and visited the business. Investigators witnessed the suspended agent working at the agency during the visit. Under the terms of his suspension, the agent was not permitted to be employed by any insurance-related entity.

Disposition: The suspended agent's license was revoked and the agency and its agent in charge were each fined $3,500 for aiding and abetting a suspended agent and placed on probation for one year.

Case: The Department received a complaint from the Florida Workers' Compensation Joint Underwriting Association, Inc. (FWCJUA) alleging the agent in charge/owner of a general lines agency was charging unlawful fees. According to the complaint, four clients of the agency stated they had been charged "service fees" ranging from $150 to $455. As a result of its investigation, the FWCJUA revoked the agency's privilege to write business. Investigators obtained statements from agency customers confirming unlawful fees were charged.

Disposition: The agency was fined $5,000 and placed on probation for one year.

Case: Investigators scheduled a bail bond agency inspection based on information unlicensed employees were conducting bail bond business. The individual was found to be quoting premiums for bail bonds, arranging for a premium payment plan for the indemnitor and scheduling time for the defendant and indemnitors to come into the bail bond agency to complete the remainder of the paperwork.

After arrival at the agency for the inspection, investigators asked the designated primary bail bond agent for the daily bond register and a copy of the designation of primary bail bond agent form the agency filed with the Department. The primary bail bond Agent could not produce either. Investigators scanned agency client files for review and found missing informational notices, incomplete applications, and missing pre-numbered premium and collateral receipts. The primary bail bond agent, who is also the owner of the agency, was unable to provide evidence of a collateral bank account for the agency.

During the investigation, it was discovered that the subject utilized a third party to unlawfully distribute the agency's business cards on the premises of the jail.

Disposition: The agency was fined $5,000 and placed on probation for one year.

Case: Investigators' review of a Public Adjuster's contract referred from Consumer Service determined the contract failed to indicate the type of claim, whether the claim was emergency, non-emergency or supplemental claim, and did not include the required three-day notice of cancellation required by Florida Statutes.

Investigators obtained a copy of the claim file from the insurance company including a copy of the public adjusting contract submitted to the insurer. A contract obtained from a second insurer contained the same violations as the first one referred to investigators.

During the course of the investigation, the adjuster's street address recorded on the contracts used an address that was a postal box at a UPS location rather than a street address as required by Florida Statutes.

Disposition: Fined $2,500.

Case: An insurer alleged an agent routinely misled his clients to believe that in order to be eligible to purchase health insurance through the Affordable Care Act (ACA), they needed to buy life insurance policies. To avoid disclosure of life insurance application forms to the consumer, the agent fraudulently signed the insureds' names without their knowledge or consent. In at least one instance, the agent grossly understated a consumer’s true income on ACA forms so the consumer would qualify for a higher government subsidy, which later created a large tax liability for the consumer. Investigators obtained statements from affected consumers and documentation from the insurer during the course of the investigation of the agent's activities.

Disposition: Suspended for two years and ordered to pay $1,615 restitution.

Case: Investigators received a complaint from Consumer Services alleging an agent wrote a life insurance policy for a lower face amount than the consumer expected. The consumer also stated his signature was forged on both the application and the cancellation request for the existing policy which was being replaced.

During the course of the investigation, at least four additional consumers were discovered to have been misled regarding the face amount of insurance policies solicited by the agent.

Disposition: Fined $3,500, placed on probation for one year, and required to complete at least five additional hours of continuing education in Ethics.

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