(AW) Me Pe THE TREASURER OF THE STATE OF FLORIDA . DEPARTMENT OF INSURANCE TOM GALLAGHER YN THE MATTER OF: HENRY VAN BAALEN, SR. / ADMINISTRATIVE COMPLAINT TO; HENRY VAN BAALEN, SR., 15653 129 Place North Jupiter, Florida 33478 -0971 HENRY VAN BAALEN, 8R., FUTURE PLANNING CONSULTANTS, INC. 17888 133 Trail North P.O. Box 971 Jupiter, Florida 33478-0971 You, HENRY VAN BAALEN, SR., are hereby notified that the Insurance Commissioner of the State of Florida has caused to be made an investigation of your activities while licensed as an insurance agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS L. Pursuant to Chapter 626, Florida Statutes, you, HENRY VAN BAALEN, SR., license I.D. No. A271442, are currently licensed in this State as a life insurance agent (2- 16). 2. On November 20, 1996, the Department issued a Consent Order in Case Number 15895-96-A, whereby, you, HENRY VAN BAALEN, SR., agreed to refund the amount of $180.00 to Rigoberto Hernandez for misrepresenting that a life insurance policy was required to secure college loans. ek a aan a a a a i NL nana 3. On November 5, 1999, your, HENRY VAN BAALEN, SR., life insurance license was suspended in Case Number 20036-97-A for three (3) months, followed by twelve (12) _ months probation, for allowing another person to transact business under your insurance license or appointment. 4. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Insurance has jurisdiction over your insurance licenses and appointments. 5. At all times pertinent to the dates and occurrences referred to herein, you, HENRY VAN BAALEN, SR., were a corporate Director and President of Future Planning Av Consultants, Inc., and incorporated Florida insurance agency doing business in Jupiter, Florida. A COUNT I 6. The General Allegations set forth in Paragraphs 1 through 5 above are hereby realleged and fully incorporated herein by reference, 7. On or about December 1998, you, HENRY VAN BAALEN, SR., contacted Patricia Meyer by telephone to request and schedule an appointment for the purpose of obtaining college loans for Ms. Meyer’s daughter, Alisha Meyer. 8. On or about December 4, 1998, you, HENRY VAN BAALEN, SR., went to Ms. Meyer’s residence and represented to her that you were familiar with obtaining college loans. You, HENRY VAN BAALEN, SR, old 1 Mis. Meyer that j you could obtain a $5 000 federal student loan for Ms. Meyer’ s daughter. 8 You, HENRY VAN BAALEN, SR, » misrepresented to Mts. Meyer that in order o “safeguard” the student Joan, a . monthly deduction of $60. 00 from Mrs. s: Meyer s checking account was s required fora period of three @) years, cenmne ee| ervey Ae nce nee a Al VT AL LAS a eA eR a 10. You, HENRY VAN BAALEN, SR, gave Mrs. Meyer a Federal Student Loan form to sign but told Mrs. Meyer the form was outdated and that your son, Ralph Henry Van Baalen, Jr., would contact her to complete the transaction. You, HENRY VAN BAALEN, SR., told Mrs. Meyer that you needed her to make a decision on the loan that very night because President Clinton was going to change the student loan programs. il. You, HENRY VAN BAALEN, SR, misrepresented to Mrs. Meyer that in order to secure the loan, her daughter, Alisha, would be required to undergo a health screening and have blood drawn to ensure Alisha was in good health and not using drugs. 12. Asadirect result of your misrepresentations regarding the Federal Student Loan program, Mrs. Meyer signed a form authorizing a nurse to examine Alisha, and an automatic withdrawal form for a $188,466 life insurance policy with Massachusetts General Life Insurance Company for what she believed was security for her daughter’s $5,000 college loan. 13. | You, HENRY VAN BAALEN, SR., caused Mrs. Meyer to be charged $180.00 for a life insurance policy with Massachusetts General Life Insurance Company that Mrs. Meyer did not want, did not know she was being charged for, and would not have agreed to purchase if she had been informed of the cost. 14. The signature purporting to be that of Patricia Meyer’s on the life insurance application to Massachusetts General Life Insurance Company is a forgery. 15. The signature purporting to be that of Patricia Meyer’s on the “Delivery Notice” dated December 12, 1998, is a forgery. IT IS THEREFORE CHARGED that you, HENRY VAN BAALEN, SR., have violated or are accoufitable under the following provisions of the Florida Insurance Code and Rules of the Department of Insurance which constitute grounds for the suspension or revocation of your licenses, registrations, and appointments as an insurance agent: (a) Willful misrepresentation of any insurance policy or annuity contract or willful deception with regard to any such policy or contract. [Section 626.61 1(5), Florida Statutes]. (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Fraudulent or dishonest practices in the conduct of business under the license or appointment. {Section 626.611(9), Florida Statutes]; (4) Willful failure to comply with, or willful violation of, an order or rule of the [Department of Insurance] or willful violation of any provision of [the Florida Insurance Code]. [Section 626.611(13), Florida Statutes]; . (e) Violation of any provision of [the Florida Insurance Code] or any other law applicable to the business of insurance in the course of dealing under the license or permit. [Section 626.621(2), Florida Statutes]; (f) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; - (g) No person shall engage in this state in any trade practice which is defined in this part as, or determined pursuant to [Sections 626.951 or 626.9561, Florida Statues] to be, an unfair method of competition or an unfair or deceptive act or practice involving the business of insurance. [Section 626.9521(1), Florida Statutes]; (h) Knowingly making a false or fraudulent written or oral statement or ‘Tepresentation on, or relative to, an application or negotiation for an insurance policy for the purpose of obtaining a fee, commission, money, or other benefit from any insurer, agent, broker, or individual. [Section 626.9541(1)(k)I., Florida Statutes]; = - COUNT 15. | The General Allegations set forth in Paragraphs 1 through 5 and in Count I above are hereby realleged and fully incorporated herein by reference. 16. Onor about the summer of 1993, your son, Ralph Henry Van Baalen, Jr., contacted Robert Louis Capobianco by telephone to discuss obtaining college loans. 17. Onor about September 1993, your son Ralph Henry Van Baalen, Jr., visited the home Robert Louis Capobianco of Palm Beach Gardens, Florida, on the pretense of providing information on college loans. In fact, your son Ralph Henry Van Baalen, Jr., went to the Capobianco’s home in order to solicit an application for a life insurance policy. 18. Atthis time, Ralph Henry Van Baalen, Jr., was not licensed as an insurance agent in the state of Florida by virtue of the fact that his insurance licenses were suspended on September 3, 1992, for a period of two (2) years. . 19. Your son, Ralph Henry Van Baalen, Jt., misrepresented to the Mr. Capobianco that, in order to secure a student loan, Mr. Capobianco was required purchase a life insurance policy with Southern Security Life Insurance Company at a cost of $60.00 per month. 20. As a direct result of Ralph Henry Van Baalen, Jr.,’s misrepresentations concerning the college loan program and the life insurance policy, your son, Ralph Henry Van Baalen, Jr., caused Mr. Capobianco to be charged $60.00 per month for a life insurance policy with Southern Security Life Insurance Company that was not required in order to obtain a student loan. 21. Onor about 1995, your son, Ralph Henry Van Baalen, Jr., met with Mr. Capobianco and misrepresented that is was necessary to change the life insurance policy with Southern Security Insurance Company because he had a better working relationship with Life USA insurance company. uteri that your s son, Ral h Hi 22. Ralph Henry Van Baalen, Jr., failed to disclose the real reason for the to change to a life insurance policy with Life USA Insurance Company was because you, HENRY VAN BAALEN, were terminated as an agent with Southem Security Insurance Company for permitting your son, Ralph Henry Van Baalen, Jr., to solicit insurance without a license. 23. ) Based on misrepresentations made by Ralph Henry Van Baalen, Jr., Mr. Capobianco signed his son’s name to the life insurance application with Life USA. 24, — Your son, Ralph Henry Van Baalen, Jr., solicited an insurance policy and assisted Mr. Capobianco with preparing the application for the life insurance policy with Southern Security Life Insurance Company. 25. By soliciting Mr. Capobianco, Ralph Henry Van Baalen, Jr., transacted “insurance” as defined by section 624.10, Florida Statutes, inasmuch “transact” includes solicitation or inducement, preliminary negotiations, preparation of an insurance application, effectuation of a contract of insurance; and transaction of matters subsequent to effectuation of a contract of insurance and arising out of i it. 26, Ralph Henry Van Baalen, Jr., did not sign the application a as the agent responsible Ms for accepting the application, but instead left this area “blank,” rae All | actions involving your son, Relph Henry Van Baalen, Jr., as a foresaid, were conducted with your r full knowledge and consent, You, HENRY VAN N BAALEN, SR., knew an Baal en, Jr., was s not licensed as an insurance agent in the : state eof . ‘apobianco for this policy, and signed the application as the producing & agent. 28. You, HENRY VAN BAALEN, SR., submitted Mr. Capobianco’s application to Southern Security Life Insurance Company for underwriting review. + tee eee FANS epi er = Bay FEE WS poe 29. You, HENRY VAN BAALEN, SR., permitted an unlicensed individual to transact insurance in the state of Florida. IT IS THEREFORE CHARGED that you, HENRY VAN BAALEN, SR., have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Insurance which constitute grounds for the suspension or revocation of your licenses, registrations, and appointments as an insurance agent: a. Sections 626.611(5), 626.611(7), 626.61 1(9), 626.61 1(13), 626.621(2), 626.621(6), 626.9521(1), 626.954(1)(K)1., Florida Statutes, which are more fully set forth in Counts J above and fully incorporated herein by reference. db. Knowingly aiding, assisting, procuring, advising, or abetting any person in the violation of or to violate a provision of the insurance code or any order or rule of the department. [Section 626.621(12), Florida Statutes); c. A license or appointment issued under this part is valid only as to the person named and is not transferable to another person. No licensee or appointee shall allow any other person to transact insurance by utilizing the license or appointment issued to such licensee or appointee. [Section 626.441, Florida Statutes]. COUNT UI » 32, Ralph Henry Van a Baaien, J Jr., misrepresented t to Mr. Capobianco that i in order to Southern Security Lifé Insurance Company. 33. Ralph Henry Van Baalen, Jr., told Mr. Capobianco that policy worked exactly as the previous life insurance policy Mr. Capobianco purchased back in 1993 for his son. 34. All actions involving your son, Ralph Henry Van Baalen, Jr., as a foresaid, were conducted with your full knowledge and consent. 35. Asa result of misrepresentations made by your son, Ralph Henry Van Baalen, Jr, with your full knowledge and consent you, HENRY VAN BAALEN, SR., caused Mr. Capobianco to be charged for life insurance policies that Mr. Capobianco would not have wanted had he been informed that such policies were not required to obtain student loans for his children. IT 1S THEREFORE CHARGED that you, HENRY VAN BAALEN, SR., have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Insurance which constitute grounds for the suspension or revocation of your | licenses, registrations, and appointments as an insurance agent: a. Sections 626.611(5), 626.611(7), 626.61 1(9), 626.61 1(13), 626.621(2), 626,.621(6), Section 626.621(12), 626.9521(1), 626.954(1)(k)I., and 626.441, Florida Statutes, which are more fully set forth in Counts I and If above and fully incorporated herein by - reference. WHERE ORE, you, HENRY VAN BAALEN, SR., are & hereby notified that the urance Agent 0 or to impose such lesser penalties as s may Eye me een vs 8 geips deer pang 3p | 5 tee een pre: NOTICE OF RIGHTS Pursuant to Sections 120.569 and 120.57, Florida Statutes and Rule 28-106, Florida Administrative Code (F.A.C.), you have a right to request a proceeding to contest this action by the Department. You may elect a proceeding by completing the attached Election of Rights form or filing a Petition. Your Petition or Election of a proceeding must be in writing and must be filed with the General Counsel acting as the Agency Clerk, Department of Insurance, If served by U.S. Mail the Petition or Election should be addressed to the Florida Department of Insurance at 612 Larson Building, Tallahassee, Florida 32399-0333. If Express Mail or hand delivery is utilized, the Petition or Election should be delivered to 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. The Petition or Election must be received by, and filed in the Department within twenty-one (21) days of the date of your receipt of this notice. YOUR FAILURE TO RESPOND TO THIS ADMINISTRATIVE COMPLAINT WITHIN TWENTY-ONE (21) DAYS WILL CONSTITUTE A WAIVER OF YOUR RIGHT TO REQUEST A “PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF REVOCATION. WILL BE ENTERED AGAINST YOU. If a proceeding is requested and there is no dispute of fact the provisions of Section 120.57(2), Florida Statutes would apply. In this regard you may s submit oral or written evidence in n opposition to o the action taken by this agency ora written statement challenging ¢ ihe © grounds 5 ee on a formal adversatial progecwing Pursuant to > Sections 120. 569 and 120. S70), florida Statutes. If you request this type of proceeding, the request must comply with all of the requirements of Rule 28-106, F.A.C. and contain: a) A statement identifying with particularity the allegations of the Department which you dispute and the nature of the dispute; . b) An explanation of what relief you are seeking and believe you are entitled to; c) Any other information which you contend is material. These proceedings are held before a State administrative law judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere the Department will request that the hearing be conducted in Tallahassee. Ifa hearing is requested, you have the right to be represented by counsel, or other qualified representative, to take testimony, to call and to cross-examine witnesses, and to have subpoena and subpoena duces tecum issued on your behalf. You are hereby notified that mediation under Section 120.573, Florida Statutes, is not available. | | | Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied. All prior correspondence i in this matter shall be considered freeform agency action, and r no 0 such | correspondence : shall operate asa a valid ! request for an administrative proceeding, Any request for administrative proceeding received prior to the date of this notice shall be deemed abandoned uiiless timely renewed in compliance with the guidelines as set out above. o -geTH c DATED and SIGNED this 1 “day of AUGUST _ 2001. Deputy Insurance Commissioner CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF RIGHTS has been furnished to: HENRY VAN BAALEN, SR., 15653 129 Place N., Jupiter, Florida 33478-5601, and to Future Planning Consultants, Inc., P.O. Box 971, Jupiter, Florida 3347-80971, by U.S..Certified Mail this 15 day of AUGUST , 2001. LEA LY — | DEAN AND , ESQUIRE Division of Legal Services 612 Larson Building Tallahassee, Florida 32399-033 (850) 413-4242 Florida Bar No. 0001959 fo] ww wm y Es ty 4 a Sj < z < es) a a | 3 lz a {§ é | = g = fy § z\k ——— ate A _——————— Zee 2 SSS F/2/,) ASe s} ————— a Sm ey. meses F (G/F) Om E|8 SSS ea xO s/s —— Elsfg 29 ed ESE a GT tuo, PAR ——— 5C ERR aU ala Se 4/8 > I giz —————— ae eee 2 (8 N as <(E ——= gd S 5 a fe - aiwfe wes we la

Docket for Case No: 02-002196PL