Division of Administrative Hearings, Florida
Filed: Oct. 17, 1989
The issue for determination in these proceedings is whether the Petitioner, the Department of Insurance, should discipline the Respondent, Richard Sidney Cole, under charges made in a three- count Amended Administrative Complaint. 1/ Count I charges essentially that the Respondent misrepresented to Edith Kastel the terms of a National States Insurance Company (National States) Medicare supplement insurance policy by failing to disclose the six-month waiting period for preexisting conditions and misleading her into believing that she would be fully covered under the policy immediately upon its issuance, in violation of Sections 626.611(5), 626.611(7), 626.611(8), 626.611(9), 626.611(13), 626.621(2), 626.621(6), 626.9521, 626.9541(1)(a)1., and 626.9541(1)(e)1., Florida Statutes (1989). Count II charges essentially that the Respondent (1) failed to disclose on the applications for National States medical/surgical expense coverage he completed on behalf of the Ogletrees the policies and coverages then in effect on the insured as required by the application and (2) misrepresented Jack Ogletree's physical condition by failing to disclose his heart disorder and hospitalization within five years before the application date, in violation of Sections 626.611(5), 626.611(7), 626.611(8), 626.611(9), 626.611(13), 626.621(2), 626.621(6), 626.9521, 626.9541(1)(a)6., and 626.9541(1)(e)1., 626.9541(1)(k)1. and 626.9541(1)(l), Florida Statutes (1989). Count III alleges essentially that the Respondent (1) sold Gunnar Sundstrom a National States Medicare supplement policy, telling him it was superior to the Old Southern Life Insurance Company (Old Southern) policy Sundstrom already had, (2) failed to disclose on the application he completed for Sundstrom the Old Southern policy Sundstrom already had, and (3) falsely stated on the application that the insurance being applied for was not intended to replace the Old Southern policy, in violation of Sections 626.611(5), 626.611(7), 626.611(8), 626.611(9), 626.611(13), 626.621(2), 626.621(6), 626.9521, 626.9541(1)(a)6., and 626.9541(1)(e)1., 626.9541(1)(k)1. and 626.9541(1)(l), Florida Statutes (1989), and F.A.C. Rule 4-46.003(2).Agent knowingly made material false statements on application for Medicare supplement insurance (no preexisting condition) and stating not replacement policy