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

  Vol. 8, No. 4 - June 2019

Notas de Casos

Case: An investigation was opened on the agent in charge of a general lines agency based on a referral from the Department's Division of Consumer Services alleging unlicensed individuals issued fraudulent workers' compensation Certificates of Insurance to several auto dealerships.

Investigators conducted agency inspections and obtained affidavits from affected consumers and one subject involved in the transactions. Investigators determined the agent in charge failed to supervise an unlicensed employee who collected premiums for commercial liability policies, and diverted the funds for his personal use. Additional evidence determined the employee routinely provided fraudulent certificates of insurance to unsuspecting consumers using fake policy numbers and coverage information, while under the agent in charge’s supervision.

Disposition: License suspended for twelve (12) months.

Case: An investigation was opened after a title insurance company notified the Department a title agent’s appointment was terminated for disbursing funds from the agency's escrow account for unauthorized purposes. Additional complaints were received from real estate agents and consumers alleging the agent failed to disburse funds due after closings to sellers, insurers, and other parties.

Department investigators conducted an inspection of the title agency. A review of transaction files determined the title agent failed to disburse funds owed to a seller after their closing and issued checks to banks and a private mortgagee on another closing that were returned for insufficient funds. The title agent also failed to disburse funds to property insurers for homeowners insurance premiums; failed to pay vendors for services provided, including electronic filings, appraisals, and surveys, and failed to record warranty deeds. At least one customer's escrow deposit was not refunded by the agent/agency after a property purchase was cancelled. The agency’s bank records indicated escrow funds were transferred to the operating account of the agency and converted for the title agent’s personal use.

Disposition: The title agent and title agency licenses were administratively surrendered with the full force of revocation.

Case: The Department learned a public adjuster may not have obtained the signatures of all named insureds as required on public adjusting contracts. An investigation was opened and additional violations were discovered;

The adjuster submitted a claim for mediation without the knowledge and consent of the insured; executed public adjuster contracts for compensation exceeding the maximum allowed by the Florida Statutes and allowed unlicensed individuals to adjust claims.

Other violations included failure to properly complete adjusting contracts; falsification of employment reports for a public adjuster apprentice; failure to update the firm's primary adjuster designation information and update his contact information on record with the Department.

During our investigation, the subject initially denied investigators access to his adjusting records. When the records were produced for inspection, they were incomplete.

Disposition: License suspended for six (6) months.

Case: An investigation was opened after the Department received a complaint from an insurer alleging the subject, a general lines agent and agent in charge of an agency, failed to properly supervise customer representatives working in the agency. The customer representatives were accused of falsifying or altering insurance company documents to obtain premium discounts for consumers who did not qualify for the discounts to enable the agency to quote lower premiums than others.

The insurer provided eight underwriting files to investigators which included fraudulent documents. Documents revealed fraudulent "proof" of continuity of auto coverage for at least three consumers stating the consumers held auto insurance for six to 11 years to qualify for reduced premiums.

Customer representatives also altered documents to indicate three insureds were homeowners to take advantage of another discount. None of the applicants owned homes and in one case the property appraiser's documents submitted with the application were from a different county than the applicant's address on the application.

Disposition: Monetary penalty of $3,500 including investigative costs.


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