mA AS Wh ya 8 OCT 26 200 THE TREASURER OF THE STATE.OF FLORIDA DEPARTMENT OF INSURANCE: Troesuror ang MiRLD Vac Tom GALLAGHER Ao \ ANGS Doerr Commisslaner IN THE MATTER OF: CASE NO. 42960-01-AG RICHARD DAY / ADMINISTRATIVE COMPLAINT TO: RICHARD DAY 820 Brookstone Court Jacksonville, Florida 32259 RICHARD DAY P.O. Box 19069 Jacksonville, Florida 32246 You, RICHARD DAY, are hereby notified that pursuant to Chapter 626, Florida Statutes, 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. You, RICHARD DAY, are currently licensed in the state as a life, health, and variable annuity contracts salesman, life and health insurance agent, and health insurance agent. 2. At all time pertinent to the dates and occurrences referred to in this Administrative Complaint you, RICHARD DAY, were licensed as an insurance agent in this state. COUNT I 3. Paragraphs one through two are realleged and incorporated herein by reference. — 4. On or about March 9, 2000, you, RICHARD DAY, solicited and sold to Clara F. Hepner of Jacksonville, Florida, a John Hancock Insurance Company long term care insurance policy, which she desired to purchase. 5. You, RICHARD DAY, represented to Clara F. Hepner that the long term care insurance policy would have a 100 day elimination period which was what she desired to purchase. 6. You, RICHARD DAY, without Clara F. Hepner’s knowledge or informed consent, changed the elimination period on the insurance policy to 180 days. You, RICHARD DAY, without Clara F. Heppner’s knowledge or informed consent, submitted the form amending to the policy to the insurer with the false signature of Clara F. Heppner fraudulently affixed thereto. 7. Clara F. Heppner would not have purchased the policy if she had been made aware that the policy would have a 180 day elimination period. You, RICHARD DAY, were aware of these facts. IT IS THEREFORE CHARGED that you, RICHARD DAY, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the State Treasurer and Insurance Commissioner which constitute grounds for the suspension or revocation of your insurance licenses and eligibility for licensure: (a) Willful misrepresentation of any insurance policy or annuity contract or willful deception with regards to any such policy or contract. {Section 626.611(5), Florida Statutes}; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; at od cepeeppere + sree eee Speen (c) Demonstrated lack of reasonable adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes. (d) Fraudulent or dishonest practices in the conduct of business under the license or permit. [Section 626.611(9), Florida Statutes]; (e) False statements and entries. — 1. Knowingly: a. Filing with any supervisory or other public official, b. Making, publishing, disseminating, circulating, c. Delivering to any person, d. Placing before the public, e. Causing, directly or indirectly, to be made, published, disseminated, circulated, delivered to any person, or placed before the public, any false material statement. [Section 626.9541(1)(e)f, Florida Statutes]. 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 the right to request a proceeding to contest this action by the Department. You may elect a proceeding by completing the attached Election of Rights form or filing a Petition. Your Petition or Election of a proceeding must be in writing and must be filed with the General Counsel acting as the Agency Clerk, Department of Insurance. If served by U.S. Mail the Petition or Election should be addressed to the Florida Department of Insurance at 612 Larson Building, Tallahassee, Florida 32399-0333. If Express Mail or hand delivery is utilized, the Petition or Election should be delivered to 612 Larson Building, 200 East 3 Gaines Street, Tallahassee, Florida 32399-0333. The Petition or Election must be received by, and filed in the Department within twenty-one (21) days of the date of your receipt of this notice. YOUR FAILURE TO RESPOND TO THIS ADMINISTRATIVE COMPLAINT WITHIN TWENTY-ONE (21) DAYS WILL CONSTITUTE A WAIVER OF YOUR RIGHT TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF REVOCATION WILL BE ENTERED AGAINST YOU. Ifa 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 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. oe rer leprerre ore 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. If you request a hearing, you have the right to be represented by counsel, or other qualified representative, to take testimony, to call and cross-examine witnesses, and to have subpoena and subpoena duces tecum issued on your behalf. You are hereby notified that mediation under Section 120.573, Florida Statutes, is not available. Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied. All prior correspondence 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. DATED and SIGNED this_26th _dayof ___Octoher __, 2001. . VA N\ y KENNEY SHIPLEY Deputy Insurance Commissioner or Somme gee noe wire Shad cyereeme CERTIFICATE OF SERVICE THEREBY CERTIFY that a true and correct copy of the foregoing Administrative Complaint was mailed by certified mail to: Richard Day, 820 Brookstone Court, Jacksonville, FL 32259, Richard Day, P.O. Box 19069, Jacksonville, FL 32246 on this 26th day of October , 2001. teat ZS ( James A. BOSSART, ESQUIRE” ivision of Legal Services an Larson Building Tallahassee, FL 32399-0333 (850) 413-4124 ae

Docket for Case No: 02-000066PL