a hee ilk il, lia il ‘kaa. . fh kidd ike A a FILED SEP 20 2001 THE TREASURER OF THE STATE OF FLORIDA DEPARTMENT OF INSURANCE Tom GALLAGHER : IN THE MATTER OF: CASE NO. 42471-01-AG RANDOLPH BLAKE DORCEY : / ADMINISTRATIVE COMPLAINT ADIN 1 Ra ee ug ae ta TO: RANDOLPH BLAKE DORCEY 7001 Green Acre Ln Fort Myers, Florida 33912-4120 RANDOLPH BLAKE DORCEY ion Dorcey & Associates . i c& 10181 Six-Mile Cypress, Ste. B Fort Myers, Florida 33912 RANDOLPH BLAKE DORCEY P.O. BOX 07216 Fort Myers, Florida 33919-0216 You, RANDOLPH BLAKE DORCEY, are hereby notified that pursuant to Chapter 626, Florida Statutes, the Insurance Commissioner 0 of the State of Florida, has caused to be made an investigation of your activities while licensed a: as an insurance agent in this state, as a result of which it is alleged: sao aki, ii ai a ah i a ei aa GENERAL ALLEGATIONS ; 1. You, RANDOLPH BLAKE DORCEY, License I.D. #4070704, are currently sed in the state as a life insurance agent, health insurance agent and a life, health, and _. variable annuity contracts salesman. 2. At all time pertinent to the dates and occurrences referred to in this Administrative Complaint you, RANDOLPH BLAKE DORCEY, were licensed as an insurance agent in this state. — 3. At all times pertinent to the dates and occurrences referred to in this Administrative Complaint, a contractual relationship existed between you, RANDOLPH ~~ BLAKE DORCEY, and American Equity Investment Life Insurance Company. COUNT I “4, The above general allegations are re-alleged and incorporated herein by reference. ween On or about December 9, 1999, you, RANDOLPH BLAKE DORCEY were od by Dennis DenBesten, of Ft. Myers, Florida, to discuss alternative investment options “to Annuities. “6. You, RANDOLPH BLAKE DORCEY, gave a presentation to Dennis DenBesten of alternative investment options to Annuities. | 7 You, RANDOLPH BLAKE DORCEY, were again contacted by Dennis sesten wherein he informed you of his desire to invest in Fixed Annuities. i You, RANDOLPH BLAKE DORCEY, prepared two Annuity applications and d checks from Dennis DenBesten for the investment. 9. Based upon your presentation and the source of the checks received, you, RANDOLPH BLAKE DORCEY, knew or should have known that the-source of funding for the Fixed Annuity investment was from an existing annuity that was surrendered by Mr. DenBesten. ) 10. | You, RANDOLPH BLAKE DORCEY, failed to submit a replacement form(s) for the transaction when you knew or should have known the transaction was a replacement. IT IS THEREFORE CHARGED that you, RANDOLPH BLAKE DORCEY, 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) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; } skews ; ___ (b) Fraudulent or dishonest practices in the conduct of business under the license or permit. [Section 626.611(9), Florida Statutes]; (c) Willful failure to comply with, or willful violation of, any proper order or rule of the department or willful violation of any provision of this code. [Section 626.611(13), Florida Statutes]; (d) Violation of any lawful order or rule of the department. [Section 626.621(3), 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 or having otherwise shown himself or herself to be a source of injury or loss to the public. {Section 626.621(6), Florida Statutes]; - & False statements and entries.— Bi ll i le - 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), Florida Statutes}; ® Where replacement is or may be involved, the agent shall: qj) Present to the applicant, not later than at the time of taking the application, a "Notice to Applicant Regarding Replacement of Life Insurance" in the form as described in Exhibit A. The Notice must be signed by the applicant and the agent and left with the applicant. (2) Leave with the applicant the original or a copy of all Sales Proposals used for presentation to the applicant. (3) Submit to the replacing insurer with the application, a completed copy of the "Notice to Applicant Regarding Replacement of Life Insurance" (Exhibit A) and a copy of all Sales Proposals used for presentation to the applicant. (h) Any insurer, agent, representative, officer or employee of such insurer failing to comply with the requirements of these rules and by so doing being in violation of any insurance statute of the State of Florida, as implemented by these rules, shall be subject to such penalties as may be appropriate under the applicable insurance statutes of this state. [Section 4-151.009, Florida Administrative Code]; AMAR hh ci A Mi ile aA i i i a a ak RB lh Bo alle a COUNT 1 1. . Paragraphs one through ten are re-alleged and incorporated herein by reference. 12. Onor about January 7, 2000, you, RANDOLPH BLAKE DORCEY, prépared, or assisted in preparing, an annuity application for “The Cornelius and Esther DenBesten Trust” naming Dennis G. DenBesten as annuitant. 13. . Onthe aforementioned application and in response to the question “Do you have any reason to believe that replacement of existing insurance may be involved?” you, . RANDOLPH B. DORCEY, answered in the negative. 14. \ Based upon information provided to you by Dennis DenBesten and your own presentation and receipt of moneys, you, RANDOLPH BLAKE DORCEY, knew or should have known this was a false and misleading statement. , IT IS THEREFORE CHARGED that you, RANDOLPH BLAKE DORCEY, 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) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (b) Fraudulent or dishonest practices in the conduct of business under the license or permit. [Section 626.611(9), Florida Statutes]; (c) Willful failure to comply with, or willful violation of, any proper order or rule of the department or willful violation of any Provision of this code. {Section 626. 61 1013) Florida Statutes]; od Bestia i. sil ati ka ee Rk il iad. (d) Violation of any lawful order or rule of the department. [Section 626.621(3), 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 or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) 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), Florida Statutes]; (g) 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 benfit from any insurer, agent broker, or individual. [Section 626.9541(1)(k)1., Florida Statutes]; (h) Where replacement is or may be involved, the agent shall: (1) Present to the applicant, not later than at the time of taking the application, a "Notice to Applicant Regarding Replacement of Life Insurance" in the form as described in Exhibit A. The Notice must be signed by the applicant and the agent and left with the applicant. 6 ee aes ak, i, i i, A i a A a IR coe he lia Behe. i. on, ks, ie i al ck ak cle (2) Leave with the applicant the original or a copy of all Sales Proposals used for presentation to the applicant. (3) Submit to the replacing insurer with the application, a completed copy of the "Notice to Applicant Regarding Replacement of Life Insurance" (Exhibit A) and a copy of all ‘Sales Proposals used for presentation to the applicant. (i) Any insurer, agent, representative, officer or employee of such insurer failing to comply with the requirements of these rules and by so doing being in violation of any insurance statute of the State of Florida, as implemented by these tules, shall be subject to such penalties as may be appropriate under the applicable insurance statutes of this state. [Section 4-151.009, Florida Administrative Code]; COUNT I 15. Paragraphs one through ten are re-alleged and incorporated herein by reference. 16. Onor about January 7, 2000, you, RANDOLPH BLAKE DORCEY, prepared, or assisted in preparing, an annuity application for “The Cornelius and Esther DenBesten Trust” naming Marlo DenBesten as annuitant. 17. On the aforementioned application and in response to the question “Do you have any reason to believe that replacement of existing insurance may be involved?’ ” you, RANDOLPH B. DORCEY, answered in the negative. 18. Based upon information provided to you by Dennis DenBesten and your own © presentation and receipt of moneys, you, "RANDOLPH BLAKE DORCEY, knew or should have known this was a false and misleading state @ Demonstrated lack of fitness or trustworthiness to engage in the business of surance. [Section 626. 611(7), Florida Statutes]; ©) Fraudulent or dishonest practices in the conduct of business under the license or permit. [Section 626.611(9), Florida Statutes]; _ © Willful failure to comply with, or willful violation of, any proper order or rule of the department or wiliful violation of any provision of this code. [Section 626.611(13), Florida tes]; @ Violation of any lawful order or rule of the department. [Section 626.621(3), Florida o Statutes]: ete ede de (e) Inthe conduct of business under the license or appointment, engaging in unfair oo methods of competition or in unfair or deceptive acts or practices or having otherwise shown : himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida (f) 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, fe ls A MR wl Oo oe i iit, 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), Florida Statutes]; (g) 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 benfit from any insurer, agent broker, or individual. [Section 626.9541(1)(k)1., Florida Statutes]; (h) Where replacement is or may be involved, the agent shall: (1) Present to the applicant, not later than at the time of taking the application, a "Notice to Applicant Regarding Replacement of Life Insurance" in the form as described in Exhibit A. The Notice must be signed by the applicant and the agent and left with the applicant. (2) Leave with the applicant the original or a copy of all Sales Proposals used for presentation to the applicant. | (3) Submit to the replacing insurer with the application, a completed copy of the "Notice to Applicant Regarding Replacement of Life Insurance" (Exhibit A) and a copy of all Sales Proposals used for presentation to the applicant. (i) Any insurer, agent, representative, officer or employee of such insurer failing to comply with the requirements of these rules and by so doing being in violation of any insurance statute of the State of Florida, as implemented by these rules, shall be ° subject to such penalties as may be appropriate under the applicable insurance statutes of this state. [Section 4. 151. 009, Florida Administrative Code]; evenrer Saeee Lec an lll A 5 NRO Rl A A he eo Ke ck a a, MR ak 5 in a ee cee et Sarees NOTICE OF RIGHTS 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. 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 Gaines Street, Tallahassee, Florida 32399-0300. 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 ory. In n this regard you may submit oral or r written evidence vhs in opposition to the action taken by this agency ora written statement t challenging the grounds upon which the agency has relied. While a hearing is normally not required in the ‘absence ofa 10 iin oi OR : ‘ t a q i 4 a 4 : 4 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 o you dispute and the nature of the dispute; b) — Anexplanation 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 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 a hearing is requested, you have the right to be represented by counsel, or other qualified representative, to take testimony, to call and to 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. a Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied. All prior correspondence i in this matter shall be considered freeform agency action, and no such correspondence shall operate a asa avalid request for an administrative proceeding. Any request fc for ‘administrative proceeding received prior to the date 11 phd sce abi. ; ‘ F i cee tie A be i of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. DATED and SIGNED this 20" __ day of SEPTEMBER, 2001. KENNEY SHIPLEY Deputy Insurance Commissioner 12

Docket for Case No: 02-000934PL