FILED APR 14 2014 CHIEF FINANCIAL OFFICER JEFF ATWATER STATE OF FLORIDA &, UL Docketed by IN THE MATTER OF: TERRANCE ELWOOD OLSON CASE NO.: 146796-14-AG / ADMINISTRATIVE COMPLAINT TERRANCE ELWOOD OLSON ~ 603 W. Ocala Street Umatilla, Florida 32784 You, TERRANCE ELWOOD OLSON, are hereby notified that the Chief Financial Officer of the State of Florida has cause to be made an investigation of your activities while licensed in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 626, Florida Statutes, you, TERRANCE ELWOOD OLSON, are an officer and director of Olson Insurance and Financial Services of Central Florida Inc. (hereinafter Olson Insurance), a Florida incorporated insurance agency, and are licensed in this state as a life including variable annuity and health insurance agent and as a general lines insurance agent. 2. At all times pertinent to the dates and occurrences referred to herein, you, TERRANCE ELWOOD OLSON, were licensed in this state as an insurance agent. ) ) 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (“Department”) has jurisdiction over your license. 4. At all times pertinent to the dates and occurrences referred to herein, you, TERRANCE ELWOOD OLSON, through Olson Insurance, had a contractual relationship with Citizens Insurance Company. 5. At all times pertinent to the dates and occurrences referred to herein, you, TERRANCE ELWOOD OLSON, were acting both on behalf of the corporation, Olson Insurance, as well as in your individual capacity. COUNT I 6. The above general allegations are hereby realleged and fully incorporated herein by reference. 7. On or about March 13, 2011, Michael Mitchell did inspect the roof and did submit to you, TERRANCE ELWOOD OLSON, a “Roof Condition Certification Form” for a property located at 835 E. 11™ Avenue in Mt. Dora, Florida owned by Blue Frog Homes, Inc. This was part of an application for homeowners insurance. 8. The certification form prepared by Michael Mitchell asks the question “What is the remaining life span of the roof’. The question is answered “ 1 year”. Furthermore, the certification form notes that the roof is only in “poor condition” As such, the home was not eligible for insurance. 9. The “Roof Condition Certification Form” submitted by you, TERRANCE ELWOOD OLSON, to Citizens Insurance falsely and fraudulent states that the roof has 7 years of life remaining and that the roof condition was “good”. The “Roof Condition Certification Form” submitted by you, TERRANCE ELWOOD OLSON, to Citizens Insurance was not the ) ) same Roof Certification Form prepared by Michael Mitchell and received by you. You, TERRANCE ELWOOD OLSON, were aware of or should have been aware of these facts. 10. The false roof certification form submitted by you, TERRANCE ELWOOD OLSON, was false and a material misstatement of fact. The false and material misstatements were made for the sole purpose of the issuance of an insurance policy that the insured would not otherwise have been eligible for. You, TERRANCE ELWOOD OLSON, were aware of or should have been aware of these facts. 11. You, TERRANCE ELWOOD OLSON, have knowingly submitted a false insurance document to an insurer. As a result, the insurer was liable on a risk that it would not have otherwise been liable for but for the misrepresentations. IT IS THEREFORE CHARGED that you, TERRANCE ELWOOD OLSON, have violated or are accountable under one or more of the following provisions of the Florida Statutes and/or the Florida Administrative Code, which constitutes sufficient grounds to suspend or revoke your license or appointment, or revoke your eligibility to hold a license or appointment: (a) Section 626.611(5), Florida Statutes, which provides that the Department shall suspend or revoke a license or appointment, or the eligibility to hold a license or appointment, of any person it finds willfully misrepresented any insurance policy or willfully deceived with regard to any such policy, done either in person or by any form of dissemination of information or advertising. (b) Section 626.611(7), Florida Statutes, which provides that the Department shall suspend or revoke a license or appointment, or the eligibility to hold a license or appointment, of any person it finds demonstrated lack of fitness or trustworthiness to engage in the business of insurance. ) ) (c) Section 626.611(9), Florida Statutes, which provides that the Department shall suspend or revoke a license or appointment, or the eligibility to hold a license or appointment, of any person it finds engages in fraudulent or dishonest practices in the conduct of business under the license or appointment. (d) Section 626.621(2), Florida Statutes, which provides that the Department may suspend or revoke a license or appointment, or the eligibility to hold a license or appointment, of any person it finds has violated any provision of the Insurance Code or any other law applicable to the business of insurance in the course of dealing under the license or appointment. (e) Section 626.621(6), Florida Statutes, which provides that the Department may suspend or revoke a license or appointment, or the eligibility to hold a license or appointment, of any person it finds engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under Part X of this Chapter. (f) Section 626.9541(1)(e)1, Florida Statutes, which provides that knowingly making any false material statement is an unfair or deceptive act or practice. (g) Section 626.9541(1)(k)1, Florida Statutes, which provides that knowingly making a false or fraudulent written statement on an insurance application is an unfair or deceptive act or practice. WHEREFORE, you, TERRANCE ELWOOD OLSON, are hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking your licenses, appointments and your eligibility for licensure as an insurance agent in this state or to impose such penalties as may be provided under the provisions of Sections 626.611, 626.621, 626.681, 626.691, 626.692, and 626.9521, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. You are further notified that the ) ) Department intends to seek aggravation of all such penalties in accordance with the provisions of Rule 69B-231.160, Florida Administrative Code, and that any order entered in this case revoking or suspending any license or eligibility for licensure held by you shall also apply to all other licenses and eligibility held by you under the Florida Insurance Code. 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 28-106, Florida 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 Julie Jones, DFS Agency Clerk, at the Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0390. 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. FAILURE TO ENSURE YOUR WRITTEN RESPONSE IS RECEIVED BY THE DEPARTMENT 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 A CEASE AND DESIST ORDER SHALL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the requirements of Rule 28-106.2015, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, your response must contain: ) ) (a) The name, address, and telephone number, and facsimile number (if any) of the respondent (for the purpose of requesting a hearing in this matter, you are the "respondent". (b) The name, address, telephone number, facsimile number of the attorney or qualified representative of the respondent (if any) upon whom service of pleadings and other papers shall be made. (c) A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. (d) A statement of when the respondent received notice of the administrative complaint. (e) A statement including the file number of the administrative complaint. 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 free form 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 been received by the Department. th . DATED and SIGNED this_\4"" day of Aor \ 2014. Gregory Thomas : 4 Director, Agent & Agency Services ) ) 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: Terrance Elwood Olson via electronic mail at OLSONINS@ :LCIA.COM or Terrance Elwood via U.S. Certified Mail at 603 W. Ocala Street Umatilla, Florida 32784 this pe day of A Pc 1 \ ; es A. Bossart epartment of Financial Services ivision of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4124

Docket for Case No: 14-002082PL