FILED JUL: 1 2 17 CHIEF FINANCIAL OFFICER JIMMY PATRONIS STATE OF FLORIDA Docketed by IN THE MATTER OF: MARIO SANTANA CASE NO.: 179565-15-AG / ADMINISTRATIVE COMPLAINT TO: Mario Santana 899 Nandina Drive Weston, Florida 33327 Mario Santana is hereby notified that the Chief Financial Officer of the State of Florida has cause to be made an investigation of his activities while licensed in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1, Pursuant to chapter 626, Florida Statutes, Mario Santana is licensed in this state as a customer service representative. 2. At all times pertinent to the dates and occurrences referred to herein, Mario Santana was licensed in this state as a customer service representative. 3, Pursuant to chapter 626, Florida Statutes, the Florida Department of Financial Services (the Department) has jurisdiction over Mario Santana’s insurance licenses. 4. At all times pertinent to the dates and occurrences referred to herein, Mario Santana was an employee of Corner Insurance Group, Inc., a Florida incorporated and licensed insurance agency (Corner or the Agency). 5. At all times pertinent to the dates and occurrences referred to herein, Corner had a contractual relationship with Allstate Insurance Company (Allstate), whereby Mario Santana, a licensed customer representative appointed to and employed by Corner, was a “licensed sales provider” (LSP) authorized by Allstate to solicit and submit insurance business to Allstate on behalf of the Agency. COUNT I 6. The above general allegations are hereby realleged and fully incorporated herein by reference. 7. On or about February 28, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Yarelys Inglesias as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 80 E. 59th Street in Hialeah, Florida. Allstate issued the policy. 8. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 543 9th Street in Malone (Jackson County), Florida. The insured motor vehicle’s accurate garage address is 80 E. 59th Street in Hialeah, Florida. 9. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed in the application. 10. Mario Santana, on behalf of the Agency, knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: (a) Section 626.611(1)(e), 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 cither in person or by any form of dissemination of information or advertising. (b) Section 626.61 1(1)(g), 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 626.61 1(1)(i), 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 Florida 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 IX of chapter 626. (f) Section 626.9521(1), Florida Statutes, which provides that no person shall engage in any trade practice which is defined in part [X of chapter 626 as an unfair or deceptive act or practice involving the business of insurance. (g) 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. (h) 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. (i) Section 626.9541(1)(0)2, Florida Statutes, which provides that knowingly collecting as a premium or charge for insurance any sum in excess of or less than the premium or charge applicable to such insurance, in accordance with the applicable classifications and rates as filed with and approved by the office, and as specified in the policy; or, in cases when classifications, premiums, or rates are not required by this code to be so filed and approved, premiums and charges collected from a Florida resident in excess of or less than those specified in the policy and as fixed by the insurer is an unfair or deceptive act or practice. COUNT II 11. | The above general allegations are hereby realleged and fully incorporated herein by reference. 12. On or about February 21, 2014, Mario Santana submitted an application for motor vehicle insurance to Alistate with Andres Bueno as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 901 Golden Cane Drive in Weston, Florida. Allstate issued the policy. 13. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 6445 La Crossa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 901 Golden Cane Drive in Weston, Florida. 14. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 15. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss, IT IS THEREFORE CHARGED that Mario Santana violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.611(1)(g), 626.611(1)(), 626.621(2), 626.621(6), 626.9521(1), 626.954 1(1)(e)1, 626.9541(1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT III 16. The above general allegations are hereby realleged and fully incorporated herein by reference. 17. On or about January 31, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Dale J. Acosta as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 621 Talavera Road in Weston, Florida. Allstate issued the policy. 18. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 3135 La Costa Place in Naples, Florida. The insured motor vehicle’s accurate garage address is 621 Talavera Road in Weston, Florida. 19. The false garage address listed on the application submitted by Mario Santana Rincon was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 20. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.61 1(1)(g), 626.61 1(1)(i), 626.62 1(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)1 and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT IV 21. The above general allegations are hereby realleged and fully incorporated herein by reference. 22. On or about February 26, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Jorge Gonzales as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 4303 Reflections Blvd, Apt. 203 in Sunrise, Florida. Allstate issued the policy. 23, The application submitted by Mario Santana falscly and fraudulently lists the motor vehicle’s garage address as 3135 La Costa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 4303 Reflections Blvd., in Sunrise, Florida. 24. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 25. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke your license or appointment, or revoke your eligibility to hold a license or appointment: Scctions 626.61 1(1)(c), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9541(1)(e)1, 626.9521(1), 626.9541(1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT V 26. The above general allegations are hereby realleged and fully incorporated herein by reference. 27, Onor about February 26, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with David Clancy as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 535 Lakeside Circle in Sunrise, Florida. Allstate issued the policy. 28, The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 465 La Costa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 535 Lakeside Circle in Sunrise, Florida. 29. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 30. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.61 1(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)I, and 626.9541(1)(o)2, Florida Statutes, as more particularly alleged in Count I above. COUNT VI 31. The above general allegations are hereby realleged and fully incorporated herein by reference. 32. | Onor about February 26, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Fabio Munechika as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 2627 Center Court Drive in Weston, Florida. The policy was issued. 33. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 465 La Costa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 2627 Center Court Drive in Sunrise, Florida. 34, The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 35, Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. Asa result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626,61 1(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)1, and 626.9541 (1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT VII 36. The above general allegations are hereby realleged and fully incorporated herein by reference. 37. On or about February 18, 2014, Mario Santana submitted an application for motor vehicle insurance with Thomas Marinace as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 482 SW 169th Terrace in Weston, Florida. Allstate issued the policy. 38. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 465 La Costa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 482 SW 169th Terrace in Weston, Florida. 39. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of 10 or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 40. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT VIII 41. The above general allegations are hereby realleged and fully incorporated herein by reference. 42. Onor about February 13, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Norma Rhoden as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 730 NW 39th Street in Lauderhill, Florida. Allstate issued the policy. 43, The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 6445 La Costa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 730 NW 39th Street in Lauderhill, Florida. 44, The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 45. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541 (1)(k)1 and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT IX 46. The above general allegations are hereby realleged and fully incorporated herein by reference. 47, Onor about February 13, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Jorge Benet as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 11613 SW 50th Street in Cooper City, Florida. Allstate issued the policy. 48. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 3135 La Costa Street in Naples, Florida. The insured motor vehicle’s accurate garage address is 11613 SW 50th Street in Cooper City, Florida. 49. The false garage address listed on the application submitted by Mario Santana was a false and materia] misstatement of fact. The false and material misstatement was made for - the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 50. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revokc his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(c)1, 626.9541 (1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT X 51. The above general allegations are hereby realleged and fully incorporated herein by reference. 52. On or about February 20, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Andy Cassazza as the listed applicant. Mario Santana signed as 13 the licensed sales provider. The mailing address of the applicant is listed as 1801 NW 87th Way in Pembroke Pines, Florida. Allstate issued the policy. 53. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 34108 La Costa Circle in Naples, Florida. The insured motor vehicle’s accurate garage address is 1801 NW 87th Way in Pembroke Pines, Florida. 54. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 55. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. Asa result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.61 1(1)(g), 626.61 1(1)(4), 626.621(2), 626.9541(1)(e)1, 626.9521(1), 626.9541(1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT XI 56. The above general allegations are hereby realleged and fully incorporated herein by reference. 57. Onor about February 18, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Michael Bird as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 14973 SW 50th Court in Davie, Florida. Allstate issued the policy. 58. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 2933 Hollister Road in Naples, Florida. The insured motor vehicle’s accurate garage address is 14973 SW 50th Court in Davie, Florida, 59. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 60. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.61 1(1)(g), 626.61 1(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)1, and 626,9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT XI 61. The above general allegations are hereby realleged and fully incorporated herein by reference. 62. Onor about February 19, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Leonardo Miller as the listed applicant, Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 2935 Kelsey Park Circle in Palm Beach Gardens, Florida. Allstate issued the policy. 63. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 17653 Weaver Lake Drive in Maple Grove, Florida. The insured motor vehicle’s accurate garage address is 2935 Kelsey Park Circle in Palm Beach Gardens, Florida. 64, The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 65. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. 16 IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.611(1)(e), 626.611(1)(g), 626.611(1){i), 626.621(2), 626.9521(1), 626.9541(1)(e)], 626.9541 (1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT XIII 66. The above general allegations are hereby realleged and fully incorporated herein by reference. 67. Onor about February 28, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Gerardo Gomez as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 11529 NW 84th Terrace in Doral, Florida. Allstate issued the policy. 68. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 11529 NW 84th Terrace in Naples, Florida. The insured motor vehicle’s accurate garage address is 11529 NW 84th Terrace in Doral, Florida 69. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 70. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.611(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)1, and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT XIV 71. The above general allegations are hereby realleged and fully incorporated herein by reference. 72. On or about February 28, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Octavio Maniglia as the listed applicant. Mario Santana signed as the licensed sales provider. The mailing address of the applicant is listed as 6708 San Vicente Street in Coral Gables, Florida. Allstate issued the policy. 73. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 6708 San Vicente Street in Naples, Florida. The insured motor vehicle’s accurate garage address is 6708 San Vicente Street in Coral Gables, Florida. 74. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of or should have been aware that the motor vehicle’s garage address was falsely listed on the application. 75, Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.611(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9541(1)(e)1, 626.9521(1), 626.9541(1)(k)] and 626.9541(1)(0)2, Florida Statutes, as more particularly alleged in Count I above. COUNT XV 76. The above general allegations are hereby realleged and fully incorporated herein by reference. 77, On or about February 20, 2014, Mario Santana submitted an application for motor vehicle insurance to Allstate with Diana and Yovany Certuche as the listed applicants. Mario Santana signed as the licensed sales provider. The mailing address of the applicants is listed as12606 NW 14th Place in Sunrise, Florida. Allstate issued the policy. 78. The application submitted by Mario Santana falsely and fraudulently lists the motor vehicle’s garage address as 12606 NW 106th Street in Naples, Florida. The insured motor vehicle’s accurate garage address is 12606 NW 14th Place in Sunrise, Florida 79. The false garage address listed on the application submitted by Mario Santana was a false and material misstatement of fact. The false and material misstatement was made for the sole purpose of premium evasion and obtaining a commission. Mario Santana was aware of 19 or should have been aware that the motor vehicle’s garage address is falsely listed on the application. 80. Mario Santana has knowingly collected as a premium a sum less that the premium applicable to such motor vehicle insurance. As a result, the insurer was deprived of the difference between the lesser false quoted submitted premium and the greater true premium, and has suffered a financial loss. IT IS THEREFORE CHARGED that Mario Santana has violated or is accountable under one or more of the following provisions of the Florida Statutes, which constitutes sufficient grounds to suspend or revoke his license or appointment, or revoke his eligibility to hold a license or appointment: Sections 626.61 1(1)(e), 626.611(1)(g), 626.611(1)(i), 626.621(2), 626.9521(1), 626.9541(1)(e)1, 626.9541(1)(k)1, and 626.9541 (1)(0)2, Florida Statutes, as more particularly alleged in Count I above. 20 WHEREFORE, Mario Santana is hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking his license, appointments, and 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. Mario Santana is further notified that the Department intends to seck 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 him shall also apply to all other licenses and eligibility held by him under the Florida Insurance Code. / DATED and SIGNED this ] Oey of _ JU by , 2017. & Gregory Thomas, Director, Division of Insurance Agent & Agency Services 21 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 chapter 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 THAT 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 FINAL ORDER OF SUSPENSION OR REVOCATION WILL 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"). 22 (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 shal] 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) — Astatement 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 procecding 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. 23 CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been furnished by U.S. Certified Mail to: Mario Santana at 899 Nandina Drive, Weston, Florida 33327, this [lh of ul uy ,2017. les A. Bossart, Esq. artment of Financial Services Office of the General Counsel 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4124 25 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES OFFICE OF THE GENERAL, COUNSEL IN THE MATTER OF: Case No. 179565-15-AG MARIO SANTANA ELECTION OF PROCEEDING I have received and have read the Administrative Complaint filed by the Florida Department of Financial Services ("Department") against me, including the Notice of Rights contained therein, and I understand my options. 1 am requesting disposition of this matter as indicated below. (CHOOSE ONE) 1. { ] Idonot dispute any of the Department’s factual allegations and I do not desire a hearing. | understand that by waiving my right to a hearing, the Department may enter a final order that adopts the Notice of Temporary Suspension and imposes the sanctions sought, including suspending or revoking my licenses and appointments as may be appropriate. 2. I do not dispute any of the Department's factual allegations and I hereby elect a proceeding to be conducted in accordance with Section 120.57(2), Florida Statutes. In this regard, I desire to (CHOOSE ONE): [] Submit a written statement and documentary evidence in licu of a hearing; or [] Personally attend a hearing conducted by a department hearing officer in Tallahassee; or f] Attend that same hearing by way of a telephone conference call. 3. [ ] 1 do dispute one or more of the Department's factual allegations. I hereby request a hearing pursuant to Section 120.57(1), Florida Statutes, to be held before the Division of Administrative Hearings. [ have attached to this election form the information required by Rule 28-106.2015, Florida Administrative Code, as specified in subparagraph (c) of the Notice of Rights. Specifically, i have identified the disputed issues of material fact. TO PRESERVE YOUR RIGHT TO A HEARING, YOU MUST FILE YOUR RESPONSE WITH THE DEPARTMENT OF FINANCIAL SERVICES WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THE NOTICE OF TEMPORARY SUSPENSION. THE RESPONSE MUST BE RECEIVED BY THE DEPARTMENT NO LATER THAN 5:00 P.M. ON THE TWENTY-FIRST DAY AFTER YOUR RECEIPT OF THE NOTICE OF TEMPORARY SUSPENSION. The address for filing is: Julie Jones, DFS Agency Clerk, Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0390. Signature Print Name Date: Address: Date Administrative Complaint Received: If you are represented by an attorney or qualified Phone No.: representative, please attach to this election form his or her name, address, telephone and fax numbers Fax No.: 26

Docket for Case No: 17-005516PL