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

  Vol. 7 No. 2 March 2019

Notas de Casos

Case: An investigation was opened after multiple insurance companies alleged a public adjuster had a financial interest in water restoration and construction companies. In addition, the subject failed to obtain both insureds' signatures on a public adjusting contract submitted to an insurance company as required by statutes.

Marriage records showed the subject and the owner of the water restoration and construction companies were married. Bank information revealed payments from the adjusting firm to the water restoration company and proved the firm deposited monies into the construction company’s bank account. Property records for the address listed on the public adjusting contracts showed the warranty deed and the mortgage are in both the subject and spouse’s names. The address the subject used on his license record is a mail box at a retail mail box rental facility. The rental application for the box confirmed the subject and his spouse had rented the mail box. A second property was located that is deeded in the name of the subject and his spouse. This property has a Homestead exemption filed on it. Investigators went to the Post Office where the water restoration company rented a mail box. During our visit, we observed as mail was picked up from the mail box of the water restoration company. Post Office Officials obtained identification form the person getting the mail and it was the subject of our investigation.

Review of the public adjuster's contracts confirmed the subject failed to obtain the signature of all named insureds on all contracts, and all contracts were signed on the date of loss, indicating the subject failed to comply with the required 48 hour waiting period.
Disposition: Fined $5,000.00.

Case: A children's day care center gave a $4,600 down payment to its agent for renewal of its general liability, workers compensation and property policies. When the center received a non-renewal notice for one policy and a cancellation notice for another, it filed a complaint with the Department. The center provided copies of the negotiated premium check and Certificates of Insurance (COI) provided by the agent. An investigator contacted the three companies involved, and determined the agent was not appointed with one of the companies, and the policy number on the COI belonged to another insured. The second policy was cancelled for non-payment, and the third was non-renewed the previous year. The investigator established the agent issued fraudulent Certificates of Insurance and misappropriated the center's insurance premium.
Disposition: License revoked.

Case: An investigation was opened based on a termination for cause letter from an insurance company alleging the subject submitted several life insurance applications without the consent and knowledge of the insureds. Investigators obtained affidavits from the insurance company, consumers, and documentation from the insurance carrier. The applications in question contained false personal information. One of the applicants was a senior, who was blind and confined to a nursing home at the time of the application. All the applications reviewed had false addresses and phone numbers listed for the applicants. The subject admitted he submitted these applications.
Disposition: Suspended for six months.

Case: Information received from a jail alleged a bail bond agent moved his agency but did not submit the new address information to the department within 10 days as required.

Department investigators attempted to conduct an inspection of the bail bond agency's records on seven occasions on different days and times. The agency was closed when investigators visited the agency and a note was posted on the door directing visitors to call a phone number for assistance. Eventually, the bail bond agent was reached and an inspection was performed.

Review of the bail bond agency files revealed the bail bond agent was charging an unlawful fee, in addition to the premium, to travel to a jail outside of his resident county to post a bond. The bail bond agent also failed to include the agency’s complete address on his advertisements and failed to submit a new Designation of Primary Bail Bond Agent form to the department.
Disposition: Fined $5,000 and placed on probation for one year.

Case: An investigation was opened on a title insurance agency for failure to designate a licensed and appointed title agent in charge of the agency. Investigators conducted an inspection and determined an individual who was not properly licensed and appointed was signing and issuing policies for the agency.

During the inspection, the unlicensed individual told investigators she signed policies as the agent in charge. Records from the Bureau of Licensing show the individual lost her appointment in 2009 for failing to comply with Continuing Education requirements, and was never reinstated. The Bureau of Licensing sent a notice in 2011 warning the individual her license would be terminated in six months if the licensee failed hold an appointment for 48 consecutive months. In 2012, the license expired.

The unlicensed person contacted the Bureau of Licensing in 2015 to find out the status of her license. The individual was advised the insurer, which failed to appoint her, would need to complete an inadvertent error affidavit before the department could consider backdating an appointment and reinstating the license. The department received the affidavit nearly two years after the individual was advised of the requirement.

Investigators obtained numerous documents proving the individual was transacting insurance without the proper license and appointment for years. As a result of our investigation, the unlicensed person withdrew her request for reinstatement.
Disposition: Fined $7,500.

Case: A referral from the Office of Insurance Regulation alleged a Home Warranty and Automobile Warranty agent provided coverage and assumed the risk, after its contract with a warranty company expired. The “warranties” were not backed by an authorized insurer. The Office of Insurance Regulation ultimately issued a Cease and Desist order prohibiting the subject from acting as an unauthorized insurer. A review of the documentation confirmed the licensee was in violation of s.626.901(1), F.S. Investigators discovered the subject provided quotes and offered life insurance to Florida residents without being properly licensed or appointed to do so.
Disposition: Administrative license surrender.


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