a. JUN a1 2001 THE TREASURER OF THE STATE OF FLORIDA ; DEPARTMENT OF INSURANCE TOM GALLAGHER IN THE MATTER OF: CASE NO.: 40073-01-AG INES JOANNA FERNANDEZ O| - OVID. ADMINISTRATIVE COMPLAINT TO: INES JOANNA FERNANDEZ 8232 NW 8" Street Miami, Florida 33126-3983 INES JOANNA FERNANDEZ DADE INSURANCE AGENCY 921 SW 27" Avenue Suite 2B Miami, Florida 3313504646 You, INES JOANNA FERNANDEZ, 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 1. Pursuant to Chapter 626, Florida Statutes, you, INES JOANNA FERNANDEZ, license I.D. No. A296769, are currently licensed in this State as general lines insurance agent (2- 20) and Health Insurance Agent (2-40). 2. At all times relevant to the dates and occurrences set forth herein, you, INES JOANNA FERNANDEZ, were licensed in this State asa general lines insurance agent, and a health insurance agent. : ' -* 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Insurance has jurisdiction over your insurance licenses and appointments. 4. Pursuant to Section 626.561, Florida Statutes, all premiums, return premiums, or other funds belonging to insurers, insureds and others received by you, INES JOANNA FERNANDEZ, constituted trust funds, received in a fiduciary capacity, and you, INES JOANNA FERNANDEZ, were and remain obligated to account for and pay such funds to the insurer, insured, or other persons lawfully entitled thereto in the applicable regular course of business. . . COUNT I 5. The General Allegations set forth in Paragraphs 1 through 4 above are hereby realleged and fully incorporated herein by reference. 6. At all times relevant hereto, you, INES JOANNA FERNANDEZ, were not licensed to sell Tegal expense insurance and were not appointed with LMO America Legal Expense Insurance Corporation asa registered agent to sell legal expense policies. 7. You, INES JOANNA FERNANDEZ, sold legal expense policies from LMO America Legal Expense Insurance Corporation to the following individuals on or about the date indicated: a. On < or r about uly’ 7, 1999, a $75. 00 policy to Carola Equiagaray, 2107 Secoffee Street #4, Coconut Grove, Florida 33133. b. On or about August 5, 1999, a $75. 00 polley to to Anabel Ordaz, 3060 W Flagler Street 4, Miami, Florida 31353, ‘ 1 OF F about huly 15, 1999, a $95. 00 Opole to Gabriel Lopez 940 as Street 45, Miami Beach, Florida 33139. sh d. On or about April 8, 1999, a $215.00 policy to Roberto Hernandez, 1950 NW i9t Avenue, Miami, Florida 33125. e. On or about June 4, 1999, a $115.00 policy to Daniel Linares, 6220 E. 4 Avenue, Hialeah, Florida 33013. f. On or about May 27, 1999, a $95.00 policy to Carmen Toro, 13781 SW 66 Street #B120, Miami, Florida 33183. g. On or about April 10, 1999, a $75.00 policy to Olga Cotto, 5966 NW 39 Street, Miami, Florida 33166. h. On or about April 14, 1999, a $95.00 policy to Manuel Diaz Catro, 825 Brickell Bay Drive #1542, Miami, Florida 33131. . i. On or about July 22, 1999, a $75.00 policy to Danilo Hernandez, 536 SW 7 Street, Miami, Florida 33130. IT IS THEREFORE CHARGED that you, INES JOANNA FERNANDEZ, 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) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes}; (b) 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]; (c) 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. | { 1 ! Seni ie [Section 626.621(2), Florida Statutes); (d) An agent may place with an insurer only such business for which he or she is appointed and which the insurer by which he or she is appointed is authorized to write. [Section 626.752(2). Florida Statutes]; (e) No person may solicit, negotiate, sell, or execute legal expense insurance contracts on behaif of an insurer in this state unless such person is licensed and appointed as a sales Tepresentative or is licensed and appointed under the insurance code as a general lines agent or solicitor. [Section 642.034, Florida Statutes]. | COUNT II 8. The General Allegations set forth in Paragraphs 1 through 4 above are hereby realleged and fully incorporated herein by reference. 9. Between January to September 1999, you, INES JOANNA FERNANDEZ, you wrote automobile insurance with Connecticut Indemnity Insurance Company. 10. Atall times pertinent to the dates and allegations contained herein you, INES J OANNA FERNANDEZ, were not appointed with the Connecticut Indemnity Company as a registered agent. | - . 11. You, INES J OANNA FERNAN DEZ, misrepresented the addresses of insureds on applications to Connecticut Indemnity Insurance Company in order to place the insureds in a less expensive rating territory, thereby lowering the premium for the Purpose of permitting you, INES JOANNA FERNANDEZ, to sell more policies. 12. You, INES JOANNA FERNANDEZ, misrepresented to Connecticut Indemnity Insurance Company that Gabriel Lopez lived at 922 Cactus, Key Largo, Florida 33070, which is a less expensive rating district than his address at 940 8" Street #5, Miami Beach, Florida 33139, & Insurance Company th that Laureano Rodrigquez lived at it 22 Cactus, Key Largo, Florida 33070, which is the address listed on the finance agreement with Appco Finance Corporation. As a direct result of the misrepresentation, you, INES JOANNA FERNANDEZ, defrauded Connecticut Indemnity Insurance Company out of $334.00 in revenues to which it was lawfully entitled. | 13. You, INES JOANNA FERNANDEZ, misrepresented to Connecticut Indemnity Insurance Company that Carola Equiagaray lived at 2117 Secoffee Street, Key Largo, Florida 33070, which is a less expensive rating district than his address at 2117 Secoffee Street, Coconut Grove, Florida 33133, which is the address listed on the finance agreement with Appco Finance Corporation. As a direct result of the misrepresentation, you, INES JOANNA FERNANDEZ, defrauded Connecticut Indemnity Insurance Company out of $71.00 in revenues to which it was lawfully entitled, 14. You, INES JOANNA FERNANDEZ, misrepresented to Connecticut Indemnity Insurance Company that Danilo Hernandez lived at 12 Cactus, Key Largo, Florida 33070, which is a less expensive rating district than his address at 536 SW 7" Street, Miami, Florida 33130, which is the address listed on the finance agreement with Appco Finance Corporation. Asa direct result of the misrepresentation, you, IN ES JOANNA FERNANDEZ, defrauded Connecticut Indemnity Insurance Company out of $176.00 in revenues to which it was lawfully entitled. . L “ 1S -., You, INES JOANNA F ERNANDEZ, misrepresented to Connecticut Indemnity en teates a ia aba er na ee abe which is a less expensive rating district than his address at 1854, SW 9 Street, Miami, Florida 33135, which is the address listed 0 on n the finance agreement with Appeo Finance Corporation. Asa direct r result of the misrepresentation, you, INES JOANNA FERNANDEZ, defrauded Ce ee Connecticut Indemnity Insurance Company out of $159.00 in revenues to which it was lawfully entitled. 16. You, INES JOANNA FERNANDEZ, misrepresented to Connecticut Indemnity Insurance Company that Anabel Ordaz lived at 121 Cactus, Key Largo, Florida 33070, which is a less expensive rating district than her address at 3060 W. Flagler Street #4, Miami, Florida 31353 which is the address listed on the finance agreement with Appco Finance Corporation. As a direct result of the misrepresentation, you, INES JOANNA FERNANDEZ, defrauded Connecticut Indemnity Insurance Company out of $255.00 in revenues to which it was lawfully entitled. 17. A review of the five aforementioned policies reveals that you, INES JOANNA FERNANDEZ defrauded Connecticut Indemnity Insurance Company of $995.00 to which it was lawfully entitled. . IT IS THEREFORE CHARGED that you, INES JOANNA FERNANDEZ, 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, or appointments as an insurance agent: (a) Sections 626.611(7), 626.61 1(13), 626.621(2), and 626.752(2), Florida Statutes, which are more fully set forth in Counts I above and fully incorporated herein by . reference. (b) . Willful misrepresentation of any insurance policy or annuity contract or willful deception with regard to any such policy or contract. [Section 626.611(5), Florida Statutes]; | t (c) Fraudulent or dishonest practices in the conduct of business under the license or appointment. [626.611(9), Florida Statutes]; (d) Violation of the provision against twisting. as defined in s.626.9541(1). [626.621(5),Florida Statutes}: (e) 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]; (f) Knowingly making, issuing, circulating, or causing to be made, issued, or circulated, any estimate, illustration, circular, statement, sales presentation, omission, or comparison which: 1. Misrepresents the benefits, advantages, conditions, or terms of any insurance policy. [Section 626.9541(1)(a)1., Florida Statutes]; . (g) Knowingly making a false or fraudulent written or oral statement or representation on, or or relative to, an application or negotiation for an 1 insurance policy for the purpose of obtaining a fee, commission, money, or r other benefit from any insurer, agent, broker, or individual. [Section 626. 9541(1)(k)1., Florida Statutes}, : 18, The General Allegations set forth i in Paragraphs 1 through 4 above are hereby . realleged and fully incorporated herein by reference. 19. Onor about July 22, 1999, Danilo Hernandez went to Dade Insurance Agency to purchase automobile insurance. cangeiery rons cote aa dadl 20. You, INES JOANNA FERNANDEZ, misrepresented to Mr. Hernandez that the down payment on his insurance was $158.00 and that he would be required to pay the remaining balance in nine (9) monthly payments of 30.32 each. 21. Mr. Hernandez gave you, INES JOANNA FERNANDEZ, the amount of $158.00 from his checking account as down payment for what he believed was only automobile insurance. 22. The true down payment due for the automobile insurance policy with Connecticut Indemnity Insurance Company plus the cost of the legal expense insurance charged to Mr. Hernandez without his knowledge was $78.00, as is reflected in the Appco premium finance agreement. . 23. You, INES JOANNA FERNANDEZ, signed Mr. Hernandez's name on the automobile insurance application to Connecticut Indemnity Insurance Company, to a legal expense plan application with LMO America Legal Expense Insurance Corporation, and to the premium finance agreement with Appco Finance Corporation, all without Mr. Hernandez's consent or knowledge. 22. You, INES JOANNA FERNANDEZ, misrepresented to Mr. Hernandez that the " automobile insurance he purchased included a legal expense plan at no additional charge. You, INES J OANNA F ERNANDEZ, failed to disclose that Mr. Hernandez's down payment of $158. 00 incuded a charge of $75.00 for a legal expense plan with LMO America Legal Expense Insurance Corporation, as is reflected on the Appco premium finance agreement which Mr. Hernandez never authorized or even saw. ait Ridieshoniiananlid ra € a. 23. You, INES JOANNA FERNANDEZ, caused Mr. Hernandez’ to be charged $75.00 for a legal expense plan that he did not want, did not know he was being charged for, and would not have agreed to purchased if he had been informed of the cost. 24, You, INES JOANNA FERNANDEZ, have failed to account for or misappropriated $80.00 of Mr. Hernandez's payment that he made to you on July 23, 1999. 25. You, INES JOANNA FERNANDEZ, never sent Mr. Hernandez a copy of his insurance policy with Connecticut Indemnity Insurance Company. 26. You, INES JOANNA FERNANDEZ, misrepresented Mr. Hernandez's address on his insurance application with Connecticut Indemnity Insurance. Mr. Hernandez's actual address is 536 SW 7 Street, Miami, Florida 33130. However, you, INES JOANNA FERNANDEZ, represented to Connecticut Indemnity Insurance Company that Mr. Hernandez's address was 12 Cactus, Key Largo, Florida 33070. 27. The misrepresentation of Mr. Hernandez's address to Connecticut Indemnity . Insurance Company was to place Mr. Hernandez in a lower premium rating territory, making the policy easier to sell. This misrepresentation deprived Connecticut Indemnity of the approved insurance premiums to which is was lawfully entitled. 28. You, INES JOANNA FERNANDEZ, contacted Mr. Hernandez via the telephone and misrepresented that the Department was conducting a "routine investigation" of insurance agencies throughout the state. You, INES JOANNA FERNANDEZ, told Mr. Hernandez to disregard any letters that he received from the Department. You, INES JOANNA F ERNANDEZ, attempted to interfere with the ¢ Department’ investigation. of your activities as an insurance agent in this State. * os mE = wn IT IS THEREFORE CHARGED that you, INES JOANNA FERNANDEZ, 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, or appointments as an insurance agent: (a) Sections 626.611(5), 626.611(7), 626.611(9), 626.61 1(13), 626.621(2), 626. 621(5), 626.752(2), 626.9521(1), 626.9541(1)(a)1., 626.9541(1)(k)1. Florida Statutes, which _ are more fully set forth in Counts IJ and II above and fully incorporated herein by reference. (b) 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 or the public. [Section 626.621(6), Florida Statutes]; (c) Knowingly making a false or fraudulent written or oral statement or representation 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)1., Florida Statutes]; (d) Representing to the applicant that a specific ancillary coverage or product ‘is included in the motor vehicle policy applied for without an additional charge when such charge is required [Section 626. 9S41(1V@)2., F lorida Statutes]; and (e) Charging an n applicant f for a a specific ancillary coverage or r product, in addition to the cost of the: motor vehicle i insurance coverage applied for, without the informed consent of the applicant, [Section 626.9541(1)(z)3., Florida Statutes]. * ee ere seit Fs * é in the Deparment within twenty-one en da s of the d (f) Any individual who willfully obstructs the department or its examiner in the examinations or investigations authorized by this part is guilty of a misdemeanor and upon conviction shall be punished as provided in s. 624.15. [Section 624.31 8(6), Florida Statutes]. (g) Every policy shall be mailed or delivered to the insured or to the person entitled thereto not later than 60 days after the effectuation of coverage. WHEREFORE. you, INES J OANNA FERNANDEZ. are hereby notified that the Treasurer and Insurance Commissioner intends to enter an Order revoking your licenses registrations, and appointments as an insurance agent or to impose such lesser penalties as may be provided under the provisions of Sections 626.611, 626.621, 626.681, 626.691, arid 626,952] » Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in the Administrative Complaint. | 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. Yo tion c or Election of a Proceeding must be in writing and must be filed with the General Counsel acting as s the Agency Clerk, Department of Insurance. If served by U.S. Mail the Petition or Flection should be addressed to the F lorida Department of Insurance at 612 Larson Building, Tallahassee, F lorida 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, Tallahass ee, F lo da 32399-0333, ae Petition or Election must be ‘Teceived by, and filed of your receipt of this notice. ; YOUR FAILURE TO RESPOND TO THIS ADMINISTRATIVE COMPLAINT WITHIN TWENT Y-ONE G1) DAYS WILL ee BP bial z 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 submit oral or written evidence in opposition to the action taken by this agency or a written statement challenging the grounds upon which the agency 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. If you dispute material facts, which are the basis for this agency's action, you may request a formal adversarial proceeding pursuant to Sections 120.569 and 120.57(1), 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 an 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 Jaw judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere the Department will request that the hearing be conducted i in Tallahassee. if a hearing i is requested, you have the right to be represented by counsel, or other qualified represen ative, t stimony, to call and to cross- examine witnesses, and to have subpoena and subpoena duces tecum issued o on your r behalf. s u 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 in this matter shall be considered freeform agency action, and no such correspondence shall operate as a valid request for an administrative proceeding. Any request for 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. ceeeegre ame eee tener a RRR oe pe ere carne ere AS ae Spe ge ee cp Se er DATED and SIGNED this / [ (l day of oO" 2 ——s 2001. 7 — ~*~ / f hog KENNEY SHIPLE Deputy Insurance Commissioner ap ree teem ee SRR genre rere

Docket for Case No: 01-003017PL