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  Vol. 9, No. 2 - June 2020

Notas de Casos

Case: During a recent investigation it was determined that a licensed all-lines adjuster aided and abetted an unlicensed individual by allowing the individual to adjust 21 Florida claims for an insurer without the required license and appointment.

Disposition: Fined $5,000.

Case: The case originated from a referral from the Department's Division of Investigative & Forensic Services alleging a life, health and variable annuity agent defrauded a senior consumer and caused great financial harm.

An affidavit from the senior consumer and supporting evidence from the involved insurer proved the agent defrauded a Florida senior out of her life savings of approximately $99,000 over a period of years. The agent created fraudulent annuity documents bearing the names of fictitious insurers. The agent personally collected payments for the fraudulent annuities from the unsuspecting consumer, which he converted for his personal use.

Disposition: Permanently barred from the insurance industry. The former agent was later charged with Misappropriation of Insurance Premiums, Communications Fraud, and First-Degree Grand Theft. The criminal case remains pending.

Case: In today's busy world, and insurance agent may come to you. One consumer applied for homeowners insurance at a neighborhood park. When the policy renewal was coming up, the consumer realized he never received a policy and called the agency and was told his policy had cancelled. The premium refund was not returned to the consumer until a year later.

Upon researching the transaction, the investigator discovered the original sale at the park was performed by a customer representative. Customer representatives are prohibited from conducting insurance activities outside of an agency setting*. An agency's agent in charge and a customer representative's supervising general lines agent are responsible for the actions of a customer representative.

Disposition: The agent in charge/supervising general agent was fined $3,500, consumer restitution, and placed on probation for one year.

* Compliance requirements at time of the transaction.

Case: The case was opened when the Department received a termination for cause notice from an insurer alleging a life agent submitted three applications for insurance without the knowledge or consent of the insured.

One consumer provided an affidavit stating she never met the agent and did not sign the application for insurance with this company. The consumer also informed investigators she noticed an automatic withdrawal from her bank account from the insurer. The consumer contacted the insurance company which confirmed an application had been submitted for her. During the course of the investigation, evidence was found which led investigators to believe the agent had obtained the consumers' information from another agent he previously worked with.

Disposition: The agent was permanently barred from the insurance industry.

Case: An anonymous tip submitted to the Department's Division of Investigative & Forensic Services was referred to the Bureau of Investigation. The tip alleged a general lines agent wrote four property and casualty applications and accepted premium payments but never bound the coverage.

Investigators visited the agency to review the agency's practices. A consumer who provided her affidavit to investigators stated she became aware she had no insurance when she filed a claim after Hurricane Irma. The subject told investigators he did not want to file and Errors and Omissions claim, and ultimately paid the cost of the claim personally.

The agent reimbursement the consumer's premium paid for the policies never issued a year later, but only after the consumer asked for the refund.

Fined $5,000 and placed on probation for one year


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