[ef le FILED FEB £3 2004 DEPARTMENT OF FINANCIAL SERVICES Docksted by’, 5 %, cn a AIEEE TD, TOM GALLAGHER CHIEF FINANCIAL OFFICER ~ IN THE MATTER OF: CASE NO.: LISA SIMONE LENTZ a/k/a LISA SIMONE CASAMAYOURET ADMINISTRATIVE COMPLAINT TO: LISA SIMONE LENTZ a/k/a LISA SIMONE CASAMA YOURET ANY RISK INSURANCE 8062 W. Sample Rd. Margate, FL 33065-4714 LISA SIMONE LENTZ a/k/a LISA SIMONE CASAMAYOURET 4030 Edgewood Dr. Coconut Creek, FL 33066-1835 You, LISA SIMONE LENTZ, license I.D. #A153330, are hereby notified that the Chief Financial Officer 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 (2003), you, LISA SIMONE LENTZ, are currently licensed in this state as a Life Including Variable Annuity Agent (2-14), a Life Agent (2-16), a General Lines (Property & Casualty) Agent (2-20), and a Legal Expense Agent (2-56). 2. At all times pertinent to the dates and occurrences referred to herein, you, LISA SIMONE LENTZ, were licensed in this state as a Life Including Variable Annuity Agent (2-14), a Life Agent (2-16), a General Lines (Property & Casualty) Agent (2-20), and a Legal Expense Agent (2-56). 3. Pursuant to Chapter 626, Florida Statutes (2003), the Florida Department of Financial Services (hereinafter “Department”) has jurisdiction over your insurance licenses and appointments. 4, At all times relevant to the dates and occurrences referred to herein, you, LISA SIMONE LENTZ, were a representative of Any Risk Insurance, Inc., and authorized to sign checks issued on the Bank Atlantic account of Any Risk Insurance, Inc. In October of 2002, the Florida Department of State Division of Corporations administratively dissolved Any Risk Insurance, Inc. 5. Atall times relevant to the dates and occurrences referred to herein, you, LISA SIMONE LENTZ, represented the Fortune Insurance Company (hereinafter "Fortune"), the Florida Automobile Joint Underwriting Association (hereinafter "FAJUA"), and AIG. 6. Atall times relevant to the dates and occurrences referred to herein, all funds received by you, LISA SIMONE LENTZ, from consumers or on behalf of consumers representing premiums for insurance policies, were trust funds pursuant to Section 626.561(1), Florida Statutes (2001 and 2002), and were received in a fiduciary capacity and were to be accounted for and paid over tc the insurer, insured, or other persons entitled thereto in the regular course of business. 7. At various times curing the years 2001 and 2002, and pursuant to Section 626.752, Florida Statutes (2001 and 2002), you, LISA SIMONE LENTZ, placed customers of Any Risk Insurance, Inc. with insurers you were not appointed to represent. 8. SD. is a resident of Coral Springs, Florida. COUNTI 9. The above general allegations are hereby realleged and fully incorporated herein by reference. 10. In or around August, 2000, you, LISA SIMONE LENTZ, as a representative of Any Risk Insurance, Inc., issued to S.D. an automobile insurance policy with Fortune. 11. Onor about February 28, 2001, S.D. came to Any Risk Insurance, Inc. to renew his automobile policy. Despite his policy having already automatically terminated on February 24, 2001, you, LISA SIMONE. LENTZ, accepted S.D.'s personal check number 559 in the amount of TWO HUNDRED FORTY-THREE AND 00/100 DOLLARS, made payable to Any Risk Insurance, Inc., as a renewal of his policy and then issued to him a receipt for his payment. 12. You, LISA SIMONE LENTZ, failed to inform S.D. of his already terminated policy, accepted payment frora him based upon his good-faith belief he could still renew his insurance, and then led him te believe that his automobile insurance was indeed renewed when in fact it was not. 13. Onor about September 23, 2001, S.D. was involved in an automobile accident. Subsequent to this accident, ke discovered that he did not in fact have insurance, and that it was indeed cancelled in February of 2001. Asa result of his lack of insurance, S.D. has become personally liable for damages to the other party to the accident; damages which an insurance company would otherwise have paid for him. LoS) IT IS THEREFORE CHARGED that you, LISA SIMONE LENTZ, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your license and appointments: (a) All premiums, return premiums, or other funds belonging to insurers or others received by an agent, customer representative, solicitor, or adjuster in transactions under his or her license are trust funds received by the licensee ina fiduciary capacity. An agent shall keep the funds belonging to each insurer for which he or she is not appointed, other than a surplus lines insurer, in a separate account so as to allow the department to properly audit such funds. The licensee in the applicable regular course of business shall account for and pay the same to the insurer, insured, or other person entitled thereto. Section 626.561(1), Florida Statutes (2001). (b) If the license or appointment is willfully used, or to be used, to circumvent any of the requirements or prohibitions of this code. Section 626.61 1(4), Florida Statutes (2001). (c) Willful misrepresentation of any insurance policy or annuity contract or willful deception with regard to any such policy or contract, done either in person or by any form of dissemination of information or advertising. Section 626.61 1(5), Florida Statutes (2001). (d) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. Section 626.611(7), Florida Statutes (2001). (e) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. Section 626.611(8), Florida Statutes (2001). (f) Fraudulent or dishonest practices in the conduct of business under the license or appointment. Section 626.611(9), Florida Statutes (2001). (g) Misappropriation, conversion, or unlawful withholding of moneys belonging to insurers or insureds or beneficiaries or to others and received in conduct of business under the license or appointment. Section 626.61 1(10), Florida Statutes (2001). (h) 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 (2001). (i) Violation of any provision of this code or of any other law applicable to the business of insurance in the course of dealing under the license or appointment. Section 626.621(2), Florida Statutes (2091). (j) Violation of any lawful order or rule of the department. Section 626.621(3), Florida Statutes (2001). (k) In the conduct of business under the license or permit, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part IX 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 (2001). () 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 (2001). (m) 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), Florida Statutes (2001). COUNT II 14, The above general allegations are hereby realleged and fully incorporated herein by reference. 15. | Onorabout September 24, 2001, following his discovery that he had no insurance, $.D. came to Any Risk Insurance, Inc. to purchase insurance as replacement of that which he thought he had with Fortune. You, LISA SIMONE LENTZ, issued to 8.D. an automobile insurance policy with AIG that was under the FAJUA. You furnished to him documents that he signed and returned to you. You accepted S.D.'s personal check number 579 in the amount of TWO HUNDRED FIFTY-NINE AND 00/100 ($259.00) DOLLARS, made payable to Any Risk Insurance, to pay for said policy, and for which you issued to him a receipt and a proof of insurance card. You also informed him that his policy with AIG would be subsequently mailed to him. S.D. never received this policy. 16. In or around November, 2001, S.D. went to Any Risk Insurance, Inc. to inquire as to why he never received a copy of his policy from AIG. You, LISA SIMONE LENTZ, told him that there was a problem with AIG, and a new policy application would have to be completed. S.D. immediately called AIG to confirm; AIG informed him that neither a policy application nor a payment check for insurance for S.D. had ever been received. 17. You, LISA SIMONE LENTZ, failed to forward the premium and the policy application to AIG and, as a result of your actions, caused S.D. to not have insurance. . IT IS THEREFORE CHARGED that you, LISA SIMONE LENTZ, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your license and appointments: (a) All premiums, return premiums, or other funds belonging to insurers or others received by an agent, customer representative, solicitor, or adjuster in transactions under his or her license are trust funds received by the licensee in a fiduciary capacity. An agent shall keep the funds belonging to each insurer for which he or she is not appointed, other than a surplus lines insurer, in a separate account so as to allow the department to properly audit such funds. The licensee in the applicable regular course of business shall account for and pay the same to the insurer, insured, or other person entitled thereto. Section 626.561(1), Florida Statutes (2001). (b) ‘If the license or appointment is willfully used, or to be used, to circumvent any of the requirements or prohibitions of this code. Section 626.61 1(4), Florida Statutes (2001). (c) Willful misrepresentation of any insurance policy or annuity contract or willful deception with regard to any such policy or contract, done either in person or by any form of dissemination of information or advertising. Section 626.611(5), Florida Statutes (2001). (d) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. Section 626.611(7), Florida Statutes (2001). (e) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. Section 626.61 1(8), Florida Statutes (2001). ff) Fraudulent or cishonest practices in the conduct of business under the license or appointment. Section 626.61 1(9), Florida Statutes (2001). (g) Misappropriation, conversion, or unlawful withholding of moneys belonging to insurers or insureds or beneficiaries or to others and received in conduct of business under the license or appointment. Section 626.611(10), Florida Statutes (2001). (h) 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 1(13), Florida Statutes (2001). (i) Violation of any provision of this code or of any other law applicable to the business of insurance in the course of dealing under the license or appointment. Section 626.621(2), Florida Statutes (2001). q) Violation of any lawful order or rule of the department. Section 626.621(3), Florida Statutes (2001). (kk) In the conduct of business under the license or permit, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part IX 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 (2001). (l) 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 (2001). (m) Knowingly making a false or fraudulent written or oral statement or representation on, OF 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), Florida Statutes (2001). COUNT III 18. The above general allegations are hereby realleged and fully incorporated herein by reference. 19. | Onor about April 3, 2003, pursuant to an investigation by the Department, a special investigator went to Any Risk Insurance, Inc. to view the Brokering Agent's Register (Binder Book) for the dates $.D. purchased insurance from you, LISA SIMONE LENTZ. You advised the investigator that you did not know the whereabouts of the Binder Book. 20. At this same time, pursuant to the investigation into your activities, an inspection of the records of Any Risk Insurance, Inc. also revealed that no checks were ever written by you, LISA SIMONE LENTZ, or by any other representative of Any Risk Insurance, Inc., to either Fortune or AIG for any insurance policy for S.D. IT IS THEREFORE CHARGED that you, LISA SIMONE LENTZ, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your license and appointments: (a) All premiums, return premiums, or other funds belonging to insurers or others received by an agent, customer representative, solicitor, or adjuster in transactions under his or her license are trust funds received by the licensee in a fiduciary capacity. An agent shall keep the funds belonging to each insurer for which he or she is not appointed, other than a surplus lines insurer, in a separate account so as to allow the department to properly audit such funds. The licensee in the applicable regular course of business shall account for and pay the same to the insurer, insured, or other person entitled thereto. Section 626.561(1), Florida Statutes (2003). (b) The licensee shall keep and make available to the department or office books, accounts, and records as will enable the department or office to determine whether such licensee is complying with the provisions of this code. Section 626.561(2), Florida Statutes (2003). (c) If the license or appointment is willfully used, or to be used, to circumvent any of the requirements or prohibitions of this code. Section 626.611(4), Florida Statutes (2003). (d) Willful misrepresentation of any insurance policy or annuity contract or willful deception with regard to any such policy or contract, done either in person or by any form of dissemination of information or advertising. Section 626.611(5), Florida Statutes (2003). (e) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. Section 626.61 1(7), Florida Statutes (2003). (fp Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. Section 626.61 1(8), Florida Statutes (2003). (g) Fraudulent or dishonest practices in the conduct of business under the license or appointment. Section 626.61 1(9), Florida Statutes (2003). (h) — Misappropriation, conversion, or unlawful withholding of moneys belonging to insurers or insureds or beneficiaries or to others and received in conduct of business under the license or appointment. Section 626.611(10), Florida Statutes (2003). (i) Willful failure 1o 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 (2003). G) Violation of any provision of this code or of any other law applicable to the business of insurance in the course of dealing under the license or appointment. Section 626.621(2), Florida Statutes (2003). (k) Violation of any lawful order or rule of the department. Section 626.621(3), Florida Statutes (2003). 10 (py Every agent transacting any insurance policy must maintain in his or her office, or have readily accessible by electronic or photographic means, such records of policies transacted by him or her as to enable the policyholders and department to obtain all necessary information, including daily reports, applications, change endorsements, or documents signed or initialed by the insured concerning such policies. Section 626.748, Florida Statutes (2003). (m) The brokering agent shall maintain an appropriate and permanent Brokering Agent's Register. Section 626.752(3)(e), Florida Statutes (2003). WHEREFORE, you, LISA SIMONE LENTZ, are hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking your licenses and appointments as an insurance agent or to impose such penalties as may be provided under the provisions of Sections 626.611, 626.621, 626.681, 626.691, and 626.9521, Florida Statutes (2003), and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. 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 (2003), 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 Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Your written response must be received by the il 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) Astatement 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 reque sted and there is no dispute of material fact, the provisions of Section 120.57(2), Florida Statutes (2003), 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 12 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 (2003). 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 (2003), is not available. No Department attorney will discuss this matter with you until the response has been received by the Department of Financial a DATED and SIGNED this 2308 day of Fe brvar y 2004. KAREN CHANDLER Deputy Chief Financial Officer 13 1 HEREBY CERTIFY that a true and corre COMPLAINT and ELECTIO CERTIFICATE OF SERVICE IN OF RIGHT a/k/a LISA SIMONE CASAMAYOURET, LISA SIMONE LENTZ a/k/a LIS Coconut Creek, FL 33066-1835, b 2004. 'S has been furnis 8062 W. Sample ct copy of the foregoing ADMINISTRATIVE hed to: LISA SIMONE LENTZ Rd., Margate, FL 33065-4714; ‘A SIMONE CASAMAYOURET, 4030 Edgewood Drive, y Certified Mail this23Sday of bruaru Michael T. Ruff Florida Bar Number 0688541 Division of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-033 Phone: (850) 413-4134 Fax (850) 487-4907 14

Docket for Case No: 04-001212PL