FILED act 9 2002 THE TREASURER OF THE STATE OF FLORIDA Docketed by; un’ DEPARTMENT OF INSURANCE Tom GALLAGHER IN THE MATTER OF: 0 A) ‘Yh 15 P (a CASE NO.: 62386-02-AG RICHARD BOYCE HAYNES ae ADMINISTRATIVE COMPLAINT TO: RICHARD BOYCE HAYNES oe ° Bankers Life : 2, 5600 Mariner St, Suite 227 : Tampa, FL 33609 RICHARD BOYCE HAYNES 2886 59th Way N St. Petersburg, FL 33710 You, RICHARD BOYCE HAYNES, 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 aresult of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 626, Florida Statutes, at all times pertinent to the dates and occurrences referred to herein, you, RICHARD BOYCE HAYNES, License #A315608, were licensed in this state as 4 Health (2-40), Life & Health (2-18), and Life Including Variable Annuity (2-14) agent. 2. At all times pertinent to the dates and occurrences referred to herein, you, RICHARD BOYCE HAYNES, were licensed in this state as an insurance agent. eee 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Insurance has jurisdiction over your insurance licenses and appointments. 4. All applications for life insurance referenced in this Administrative Complaint were signed by you, RICHARD BOYCE HAYNES, attesting to the following: “I certify that I asked all the questions and truly and accurately recorded the answers contained herein.” COUNT J 5. The above general allegations are realleged and incorporated here and fully by reference. 6. On or about March 1, 2001, you, RICHARD BOYCE HAYNES, prepared and submitted two false life insurance applications to an insurer for the purpose of obtaining agent commissions. You, RICHARD BOYCE HAYNES, recorded the answers to the questions on these applications on behalf of applicants, Louise Doe and John Wilkerson of 1554 Chestnut Street, Tampa, Florida 33607, for policies to be issued through insurer, Bankers Life and Casualty Company, 222 Merchandise Mart Plaza, Chicago, Illinois 60654. 7. On Louise Doe’s application for life insurance, despite Ms. Doe’s directions to you, RICHARD BOYCE HAYNES, that she did, in fact, use tobacco, you answered the question: “Has any person to be insured: Used tobacco in the past year?” in the negative. You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Ms. Doe’s condition. 8. On Louise Doe’s application for life insurance, despite Ms. Doe’s directions to you, RICHARD BOYCE HAYNES, that she did, in fact, take medication for high blood pressure, you answered the question: “Any Heart or Circulatory Trouble?” in the negative and further refrained from checking the box marked, “High Blood Pressure.” You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Ms. Doe’s condition. 9. On Louise Doe’s application for life insurance, despite Ms. Doe’s directions to you, RICHARD BOYCE HAYNES, that she did, in fact, take medication for diabetes, you answered the question: “Any Endocrine or Metabolic Trouble?” in the negative and further refrained from checking the box marked, “Diabetes.” You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Ms. Doe’s condition, 10. On John Wilkerson’s application for life insurance, despite Ms. Doe’s directions to you, RICHARD BOYCE HAYNES, that Mr. Wilkerson did, in fact, use tobacco, you answered the question: “Has any person to be insured: Used tobacco in the past year?” in the negative. You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Mr. Wilkerson’s condition. 11. On John Wilkerson’s application for life insurance, despite Ms. Doe’s directions to you, RICHARD BOYCE HAYNES, that Mr. Wilkerson did, in fact, take medication for diabetes, you answered the question: “Any Endocrine or Metabolic Trouble?” in the negative and further refrained from checking the box marked, “Diabetes.” You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Mr. Wilkerson’s condition. 12. You, RICHARD BOYCE HAYNES, advised Ms. Doe to forge Mr. Wilkerson’s signature as an applicant for life insurance. Furthermore, you, RICHARD BOYCE HAYNES, then signed your own name as a witness to the signature of Mr. Wilkerson, a signature you knew to be a forgery. COUNT II 13. The above general allegations are realleged and incorporated here and fully by reference. 14, On or about February 22, 2001, you, RICHARD BOYCE HAYNES, prepared and submitted two false life insurance applications to an insurer for the purpose of obtaining agent commissions. You, RICHARD BOYCE HAYNES, recorded the answers to the questions on these applications on behalf of applicants, Lessie Lanier and Charlie Lanier of 3720 E. 38th Ave., Tampa, Florida 33610, for policies to be issued through insurer, Bankers Life and Casualty Company, 222 Merchandise Mart Plaza, Chicago, Illinois 60654. 15, On Lessie Lanier’s application for life insurance, despite Ms. Lanier’s directions to you, RICHARD BOYCE HAYNES, that she had, in fact, been treated for diabetes, you answered the question: “Within the past 2 years, to the best of your knowledge and belief, have you: 3) Been treated or advised by a doctor to receive treatment for: excessive use of alcohol, drug use, insulin dependent diabetes, kidney insufficiency (including dialysis), liver disease, or had an organ transplant?” in the negative. You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Ms. Lanier’s condition. 16. On Charlie Lanier’s application for life insurance, despite Mr. Lanier’s directions to you, RICHARD BOYCE HAYNES, that he had, in fact, been treated for diabetes, you answered the question: “Within the past 2 years, to the best of your knowledge and belief, have you: 3) Been treated or advised by a doctor to receive treatment for: excessive use of alcohol, drug use, insulin dependent diabetes, kidney insufficiency (including dialysis), liver disease, or had an organ transplant?” in the negative. You, RICHARD BOYCE HAYNES, knew or should have known that your response to said question was a false and material misrepresentation of Mr. Lanier’s condition. IT IS THEREFORE CHARGED, that you, RICHARD BOYCE HAYNES, have violated and 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 and eligibility as an insurance agent: (a) 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]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Fraudulent or dishonest practices in the conduct of business under the license or appointment. [Section 626.611(9), Florida Statutes]; (4) 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]; (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, as prohibited under part IX of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public or detrimental to the public interest. [Section 626.621(6), Florida Statutes}, WHEREFORE, you, RICHARD BOYCE HAYNES, are hereby notified that the Treasurer and Insurance Commissioner intends to enter an Order suspending or revoking your licenses and eligibility for licensure as an insurance agent or to impose such lesser penalties as may be provided under the provisions of Chapter 626, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. You are further notified 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 28-107, 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 the General Counsel as acting Agency Clerk, at the Florida Department of Insurance, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. 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. YOUR FAILURE TO RESPOND IN WRITING 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 AN ORDER OF REVOCATION WILL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the requirements of Rule 28-107.004, 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 and address of the party making the request, for purpose of service; (b) A statement that the party is requesting a hearing involving disputed issues of ' material fact, or a hearing not involving disputed issues of material fact; and (c) A reference to the notice, order to show cause, administrative complaint, or other communication that the party has received from the agency. 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 freeform 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 of Insurance. DATED and SIGNED this _Q7 day of Ot tober, 2002. Cp ly KENNEY SHIPLEY Deputy Insurance Commissioner AON a ed oe CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF RIGHTS has been furnished to: RICHARD BOYCE HAYNES, Bankers Life, 5600 Mariner St, Suite 227, Tampa, Florida 33609 and RICHARD. BOYCE HAYNES, 2886 59th Way N., St. Petersburg, FL 33710 by Certified Mail this Ga day of _Otteber , 2002. WILLIAM W. THARPE, J} Florida Bar Number 031241 Division of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-033 Phone: (850) 413-4110

Docket for Case No: 02-004575PL