Petitioner: DEPARTMENT OF FINANCIAL SERVICES
Respondent: DAVID S. APPLEBY
Judges: WILLIAM R. PFEIFFER
Agency: Department of Financial Services
Locations: Sarasota, Florida
Filed: Sep. 09, 2004
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, January 21, 2005.
Latest Update: Jan. 08, 2025
FLORIDA
DEPARTMENT OF
FINANCIAL SERVICES
TOM GALLAGHER ms
y
CHIEF FINANCIAL OFFICER _. ¥
STATE OF FLORIDA F [ LL iE if
AUG 5 204
IN THE MATTER OF:
Oooksted by:
- CASE NO.: 70072-04-AG
DAVID S. APPLEBY
/
CY 144 PL
ADMINISTRATIVE COMPLAINT
David S. Appleby
High Mark Securities, Inc.
500 S. Florida Avenue
Lakeland, Florida 33801
David S. Appleby
804 Orlando Avenue
Bradenton, Florida 34207
You, DAVID S. APPLEBY, are hereby notified that the Chief Financial Officer 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
1. Pursuant to Chapter 626, Florida Statutes, you, DAVID S. APPLEBY, are
currently licensed in this state as a Life & Variable Annuity Agent (2-14), Life, Health and
Variable Annuity Agent (2-15), Life Agent (2-16), Life & Health Agent (2-18), Variable
Annuity Agent (2-19), General Lines Agent (Property & Casualty Insurance) (2-20), Health
Agent (2-40), and Legal Expense Agent (2-56), having license 1.D. #A007520.
2. At all times pertinent to the dates and occurrences referred to herein, you, DAVID
S. APPLEBY, were licensed in this state as an insurance agent.
3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial
Services has jurisdiction over your insurance licenses and appointments.
4. At all times material to the dates and occurrences herein, TRG was the acronym
or pseudonym for a multitude of entities that engaged in the business of insurance, including,
but not limited to:
(a) T.R.G. Marketing, LLC
(b) T.R.G. Administration, LLC
(c) The Redwood Group, LLC
5. At all times material herein, TRG was not authorized to conduct insurance
business in the state of Florida.
6. At all times material to the dates and occurrences herein, EOS Health LLC -—
BOA (“EOS”) was not authorized to conduct insurance business in the state of Florida.
COUNT 1
7. The above general allegations are hereby realleged and fully incorporated herein
by reference.
8. On or about August 1, 2001, you, DAVID S. APPLEBY, contacted T.C. of
Sarasota, Florida, and sold her a health insurance plan with TRG to cover her and her employees.
The insurance policy was to become effective September 1, 2001.
9. T.C. paid the first premium for said health insurance with a company check for
THREE HUNDRED SEVENTY AND 00/100 ($370.00) DOLLARS.
10. Beginning in October, 2001, and continuing until around November, 2001, T.C.
paid TRG health insurance premiums. The premiums for the months of October and November,
2001, were each THREE HUNDRED SEVENTY AND 00/100 ($370.00) DOLLARS.
11. Commencing on or after October 1, 2001, TC. incurred covered medical claims
of approximately ONE THOUSAND AND 00/100 ($1000.00) DOLLARS that were presented to
TRG for payment. TRG failed to pay such claims.
IT IS THEREFORE CHARGED that you, DAVID S. APPLEBY, hzve violated or are
accountable under the following provisions of the Florida Insurance Code and Rules of the
Department of Financial Services which constitute grounds for the suspensicn or revocation of
your licenses and appointments:
(a) No person shall transact insurance in this state, or relative to a subject of
insurance resident, located, or to be performed in this state, without complying with the
applicable provisions of this Code. Section 624.11(1), Florida Statutes.
(b) Demonstrated lack of fitness or trustworthiness to engage in the business of
insurance. Section 626.611(7), Florida Statutes.
(c) Demonstrated lack of reasonably adequate knowledge and technical competence
to engage in the transactions authorized by the license or appointment. Section 626.611(8),
Florida Statutes.
(d) Violation of any provision of this Code or any other law applicable to the business
of insurance in the course of dealing under the license or appointment. Section 626.621(2),
Florida Statutes.
(e) 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 IX of
this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the
public or detrimental to the public interest. Section 626.621(6), Florida Statutes.
(f) No person shall, from offices or by personnel or facilities located in this state . . .
directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any
insurer not then authorized to transact such insurance in this state. Section 626.901(1), Florida
Statutes.
COUNT II
12. The above general allegations are hereby realleged and fully incorporated herein
by reference.
13. On or about September 1, 2001, you, DAVID S. APPLEBY, contacted S.C. and
D.C. of Sarasota, Florida, and sold them a health insurance plan with TRG to cover them and
their employees. The policy was to become effective October 1, 2001.
14. S.C. paid the October 2001 premium for said health insurance with a company
check for THREE HUNDRED SEVENTY-FIVE AND 00/100 ($375.00) DOLLARS. The
November 2001 premium for the TRG health insurance was paid by a company check for
THREE HUNDRED SEVENTY-FIVE AND 00/100 ($375.00) DOLLARS.
15. Commencing on or after October 1, 2001, S.C. and D.C. incurred medical claims
of approximately FOUR THOUSAND AND 00/100 ($4000.00) DOLLARS, which should have
been covered by TRG, but to date have not been paid.
IT IS THEREFORE CHARGED that you, DAVID S. APPLEBY, have violated or are
accountable under the following provisions of the Florida Insurance Code and Rules of the
Department of Financial Services which constitute grounds for the suspension or revocation of
your licenses and appointments:
(a) No person shall transact insurance in this state, or relative to a subject of
insurance resident, located, or to be performed in this state, without complying with the
applicable provisions of this Code. Section 624.11(1), Florida Statutes.
(b) Demonstrated lack of fitness or trustworthiness to engage in the business of
insurance. Section 626.611(7), Florida Statutes.
(c) Demonstrated lack of reasonably adequate knowledge and technical competence
to engage in the transactions authorized by the license or appointment. Section 626.61 1(8),
Florida Statutes.
(d) Violation of any provision of this Code or any other law applicable to the business
of insurance in the course of dealing under the license or appointment. Section 626.621(2),
Florida Statutes.
(e) 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 IX of
this chapter, or having otherwise shown himself or herself to be a source of irjury or loss to the
public or detrimental to the public interest. Section 626.621(6), Florida Statutes.
(63) No person shall, from offices or by personnel or facilities located in this state...
directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any
insurer not then authorized to transact such insurance in this state. Section 626.901(1), Florida
Statutes.
COUNT It
16. The above general allegations are hereby realleged and fully incorporated herein
by reference.
17. On or about August 1, 2001, you, DAVID S. APPLEBY, contacted B.C. and K.C.
of Bradenton, Florida, and sold them a joint health insurance plan with TRG. The policy was to
become effective September 1, 2001.
18. B.C. made the down payment for said health insurance policy with a personal
check for THREE HUNDRED THIRTY-FOUR AND 00/100 ($334.00) DOLLARS. The
November 2001 premium for the TRG health insurance was paid by a company check for
THREE HUNDRED SEVENTY-FIVE AND 00/100 ($375.00) DOLLARS.
19. Commencing on or after November 1, 2001, S.C. and D.C. incurred covered
medical claims and presented them to TRG for payment. TRG has failed to pay such claims.
IT IS THEREFORE CHARGED that you, DAVID S. APPLEBY, have violated or are
accountable under the following provisions of the Florida Insurance Code and Rules of the
Department of Financial Services which constitute grounds for the suspension or revocation of
your licenses and appointments:
(a) No person shall transact insurance in this state, or relative to a subject of
insurance resident, located, or to be performed in this state, without complying with the
applicable provisions of this Code. Section 624.11(1), Florida Statutes.
(b) Demonstrated lack of fitness or trustworthiness to engage in the business of
insurance. Section 626.611(7), Florida Statutes.
(c) Demonstrated lack of reasonably adequate knowledge and technical competence
to engage in the transactions authorized by the license or appointment. Section 626.611(8),
Florida Statutes.
(d) Violation of any provision of this Code or any other law applicaisle to the business
of insurance in the course of dealing under the license or appointment. Section 626.621(2),
Florida Statutes.
(e) 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 IX of
this chapter, or having otherwise shown himself or herself to be a source of irjury or loss to the
public or detrimental to the public interest. Section 626.621(6), Florida Statutes.
(f) No person shall, from offices or by personnel or facilities located in this state...
directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any
insurer not then authorized to transact such insurance in this state. Section 626.901(1), Florida
Statutes.
COUNT IV
20. The above general allegations are hereby realleged and fully incorporated herein
by reference.
21. On or about November 30, 2001, you, DAVID S. APPLEBY, informed T.C. (see
Count I above) that her TRG policy was no longer in effect, and sold T.C. a health insurance
plan with EOS.
22. T.C. paid the December 2001 and January 2002 premiums for the EOS insurance
policy with separate checks, each for FOUR HUNDRED NINETY-SEVEN AND 00/100
($497.00) DOLLARS.
23. Commencing on or after December 1, 2001, T.C. incurred covered medical claims
and presented them to EOS for payment. EOS has failed to pay such claims.
IT IS THEREFORE CHARGED that you, DAVID S. APPLEBY, have violated or are
accountable under the following provisions of the Florida Insurance Code and Rules of the
Department of Financial Services which constitute grounds for the suspension or revocation of
your licenses and appointments:
(a) No person shall transact insurance in this state, or relative to a subject of
insurance resident, located, or to be performed in this state, without complying with the
applicable provisions of this Code. Section 624.11(1), Florida Statutes.
(b) | Demonstrated lack of fitness or trustworthiness to engage in the business of
insurance. Section 626.611(7), Florida Statutes.
(c) Demonstrated lack of reasonably adequate knowledge and technical competence
to engage in the transactions authorized by the license or appointment. Section 626.611(8),
Florida Statutes.
(d) Violation of any provision of this Code or any other law applicable to the business
of insurance in the course of dealing under the license or appointment. Section 626.621(2),
Florida Statutes.
(e) 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 IX of
this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the
public or detrimental to the public interest. Section 626.621(6), Florida Statutes.
(6 No person shall, from offices or by personnel or facilities located in this state. . .
directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any
insurer not then authorized to transact such insurance in this state. Section 626.901(1), Florida
Statutes.
COUNT V
24. The above general allegations are hereby realleged and fully incorporated herein
by reference.
25. On or about November 28, 2001, you, DAVID S. APPLEBY, informed S.C. (see
Count II above) that TRG was not licensed in Florida, and then sold S.C. and D.C. a health
insurance plan with EOS.
26. S.C. paid the December 2001 premium for the EOS insurance policy with a check
for FIVE HUNDRED FIFTY-TWO AND 00/100 ($552.00) DOLLARS.
27. Commencing on or after December 1, 2001, S.C. and D.C. incurred covered
medical claims and presented them to EOS for payment. EOS has failed to pay such claims.
IT IS THEREFORE CHARGED that you, DAVID S. APPLEBY, have violated or are
accountable under the following provisions of the Florida Insurance Code and Rules of the
Department of Financial Services which constitute grounds for the suspension or revocation of
your licenses and appointments:
(a) No person shall transact insurance in this state, or relative to a subject of
insurance resident, located, or to be performed in this state, without complying with the
applicable provisions of this Code. Section 624.11(1), Florida Statutes.
(b) Demonstrated lack of fitness or trustworthiness to engage in the business of
insurance. Section 626.611(7), Florida Statutes.
(c) Demonstrated lack of reasonably adequate knowledge and technical competence
to engage in the transactions authorized by the license or appointment. Section 626.611(8),
Florida Statutes.
(d) Violation of any provision of this Code or any other law applicable to the business
of insurance in the course of dealing under the license or appointment. Section 626.621(2),
Florida Statutes.
(e) 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 IX of
this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the
public or detrimental to the public interest. Section 626.621(6), Florida Statutes.
(f) No person shall, from offices or by personnel or facilities located in this state. . .
directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any
insurer not then authorized to transact such insurance in this state. Section 626.901(1), Florida
Statutes.
WHEREFORE, you, DAVID S. APPLEBY, are hereby notified that the Chief Financial
Officer intends to enter an Order suspending or revoking your licenses and appointments as an
insurance agent or to impose such penalties as may be provided under the provisions of Sections
626.611, 626.621, 626.681, 626.691, 626.692, 626.901, and 626.9521, Florida Statutes, and
under the other referenced sections of the Florida Statutes as set out in this Administrative
Complaint
NOTICE OF RIGHTS
You have the right to request a proceeding to contest this action by the Department
pursuant to Sections 120.569 and 120.57, Florida Statutes, and Rule 28-107, F.orida
Administrative Code. The proceeding request must be in writing, signed by you, and must be
filed with the Department within twenty-one (21) days of your receipt of this notice. Completion
of the attached Election of Proceeding form and/or a petition for administrative hearing will
suffice as a written request. The request must be filed with the General Counsel as acting
Agency Clerk, at the Florida Department of Financial Services, 612 Larson Building, 200 East
Gaines Street, Tallahassee, Florida 32399-0333. Your written response must be received by the
Department no later than 5:00 p.m. on the twenty-first day after your receipt of this notice.
Mailing the response on the twenty-first day will not preserve your right to a hearing.
YOUR FAILURE TO RESPOND IN WRITING WITHIN
TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THIS
NOTICE 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 you request a proceeding, you must provide information that complies with the
requirements of Rule 28-107.004, Florida Administrative Code. As noted above, completicn of
the attached Election of Proceeding form conforms to these requirements. Specifically, your
response must contain:
(a) The name and address of the party making the request, for purpose of service;
(b) A statement that the party is requesting a hearing involving disputed issues of
material fact, or a hearing not involving disputed issues of material fact; and
(c) A reference to the notice, order to show cause, administrative complaint, or other
communication that the party has received from the agency.
If a hearing of any type is requested, you have the right to be represented by counsel or
other qualified representative at your expense, to present evidence and argument, to call and
cross-examine witnesses, and to compel the attendance of witnesses and the production of
documents by subpoena.
If a proceeding is requested and there is no dispute of material fact, the provisions of
Section 120.57(2), Florida Statutes, apply. In this regard, you may submit oral or written
evidence in opposition to the action taken by the Department or a written statement challenging
the grounds upon which the Department has relied. While a hearing is normally not required in
the absence of a dispute of fact, if you feel that a hearing is necessary, one will be conducted in
Tallahassee, Florida, or by telephonic conference call upon your request.
However, if you dispute material facts, which are the basis for the Department’s action,
you must request an adversarial proceeding pursuant to Sections 120.569 and 120.57(1), Florida
Statutes. 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, Florida.
Failure to follow the procedure outlined with regard to your response to this notice may
result in the request being denied. All prior oral communication or correspondence in this matter
shall be considered freeform agency action, and no such oral communication or correspondence
shall operate as a valid request for an administrative proceeding. Any request for an
administrative proceeding received prior to the date of this notice shall be deemed abandoned
unless timely renewed in compliance with the guidelines as set out above.
Mediation of this matter pursuant to Section 120.573, Florida Statutes, is not available.
No Department attorney will discuss this matter with you until the response has Seen received by
the Department of Financial Services.
DATED and SIGNED this_5** _ day of Kugqust 2004.
DOESN Ny re.
at Ls
NS i . A “
3N CHANDLER
Deputy Chief Financial Officer
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE
COMPLAINT and ELECTION OF PROCEEDING has been furnished to: David S. Appleby,
High Mark Securities, Inc., 500 S. Florida Avenue, Lakeland, Florida 33801, and David S.
Appleby, 804 Orlando Avenue, Bradenton, Florida 34207, by Certified Mail this Bh day of
iN yarss , 2004.
; ?
CN Q
renee 2. ( . NN
C3 ste \ \tst <
David J. Busch
Florida Bar Number 140945
Division of Legal Services
200 East Gaines St.
612 Larson Building
Tallahassee, Florida 32399-9333
Phone: (850) 413-4146
Fax: (850) 487-4907
Attorney for Department
12
Docket for Case No: 04-003199PL
Issue Date |
Proceedings |
Jan. 31, 2005 |
Subpoenas (5) filed.
|
Jan. 21, 2005 |
Order Closing File. CASE CLOSED.
|
Jan. 19, 2005 |
Motion to Relinquish Jurisdiction (filed by Petitioner).
|
Dec. 17, 2004 |
Notice of Production of Documents and Filing of Witness and Exhibit List filed.
|
Dec. 08, 2004 |
Notice of Production from Non-Party filed.
|
Dec. 08, 2004 |
Respondent`s First Set of Interrogatories to petitioner filed.
|
Dec. 08, 2004 |
Notice of Respondent`s First Set of Interrogatories to Petitioner (filed via facsimile).
|
Dec. 08, 2004 |
Notice of Respondent`s First Set of Interrogatories to Petitioner filed.
|
Nov. 16, 2004 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for January 28, 2005; 9:30 a.m.; Sarasota, FL).
|
Nov. 08, 2004 |
Motion for Continuance (filed by Respondent via facsimile).
|
Sep. 24, 2004 |
Order of Pre-hearing Instructions.
|
Sep. 24, 2004 |
Notice of Hearing (hearing set for November 19, 2004; 9:00 a.m.; Sarasota, FL).
|
Sep. 20, 2004 |
Response to Initial Order (filed by D. Busch via facsimile).
|
Sep. 10, 2004 |
Initial Order.
|
Sep. 09, 2004 |
Election of Proceeding filed.
|
Sep. 09, 2004 |
Administrative Complaint filed.
|
Sep. 09, 2004 |
Agency referral filed.
|