Apr=C7=2005 01:26am = From T9622 -P.002 F-370 83/31/2885 16:48 959487498; LEGAL SERVICES PAGE ms FLORIDA FINANCIAL SERVICES ED TOM GALLAGHER. Re oe HAR SO 205 IN THE MATTER OF: pocketed oy; OW BENEFITS AMERICA, N.A., INC., d/b/a CASE NO.: 79887-05-AG LIFE BENEFITS AMERICA, N.A., INC. ce nl oes a OS [&l&S ADMINISTRATIVE COMPLAINT TO: BENEFITS AMERICA, N.A,INC., d/b/a LIFE BENEFITS AMERICA, N.A., INC., through its President, Herberl R Buffington 415 East Paces Ferry Road, N.E. Terrace Level Atlanta, Georgia 30305-3306 BENEFITS AMERICA, N.A., INC., d/b/a LIFE BENEFITS AMERICA, N.A , INC., through its Registered Agent, Corporation Service Company 1201 Hays Sureet Tallahassee, Florida 32301 You, BENEFITS AMERICA, N A, INC., d/b/a LIFE BENEFITS AMERICA, N.Az INC. (“BENEFITS"), are hereby notified that the Chief Financial Officer of the Szate of Florida| has caused to be made an investigation of your activities while icensed as a non-resident viatical settlement broker in this state, as a result of which it is alleged: LEGATI 1. Pursuant to chapter 626, Fla. Stat., you, BENEFITS, are currently licensed in this state as a non-resident viatical settlement broker (8-67). Your license 1.D number is AOI8879 2. Atall times pertinent to the dates and occurrences referred to herein, you,. BENEFITS, were licensed in this state as a nonresident viatical settlement broker. Apr=O7~2005 01:26pm = From 7-622 P.003/014 F370 Ba/3l/Zb> leisy youdy aye. LEGAL SERVICES PaGE [62 i J COUNT I 3. The allegations contained in paragraphs |. and 2 are hereby realleged and fully incorporated by reference. 4 Documentation in BENEFITS' file for M-P.V , of Key West, Florida included, among other things, an application by M.P V for coverage with Manhattan National Life Insurance Company dated October 16, 1996 (“Manhattan Application”). 5. On the Manhattan Application, M P V answered “No” to the question “Within the past 2 years, have you been treated for or had: (h) Been diagnosed or treated by a member of the medical profession as having acavired immune deficiency syndrome (AIDS) pr AIDS related complex (ARC)?” 6. Manhattan National Life Insurance Company issued a policy to M.LP.V, with an effective date of November 25, 1996 (“Manhattan Policy”). 7. Documentation in BENEFITS’ file for M.P V included, aniong other things, a Viator Intake Form dated July 2, 2001. 8. The Viator Intake Form indicated that M P.V. had been diagnosed with HIV in 1994 9. MPV. listed his address as Key West, Florida on the Manhattan Application. Additionally, the Manhattan Application was signed by M.P.V. in Key West 10. MP Ves address is listed as Key West, Florida on the Viator imake Form. Jl. BENEFITS knew or should have known, or believed or should have believed, that MPV may have procured the Manhattan Policy by fraudulent means. 12. BENEFIT did not provide information or report M.P.V. to the Division of Insurance Fraud, as required pursuant to § 626.989(6), Fla. Stat (2001), which states in material part that “any insurer, agent, or other person licensed under the code, or an employee thereof, Apr-B7-2005 01:26pm From 7-622 = P.004/014 = F-370 i Bs/sefeoua 10.47 QweNormse LODHL SSAVLLES PAI Ye , Ww having knowledge or who believes that a fraudulent insurance act or any other act or practice which, upon conviction, constitutes a felony or a misdemeanor under the code, or under 5, 317.234, is being or has been committed shall send to the Division of Insurance Fraud a report or information pertinent to such knowledge or belief and such additional information relative thereto as the department may require.” IT IS THEREFORE CHARGED that you, BENEFITS, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department which constitutes grounds for the suspension, revocation or surrender of your non- resident viatical settlement broker and appointments, and eligibility for licensure or appointraen(: {a) Has engaged in fraudulent or dishonest practices, or otherwise has been shown to be untrustworthy or incompetent to act as a viatical settlement broker. [Section 62 6.9917(1}(b),| Fla. Stat. (2001)). (b) Has violated any provision of the insurance code os of this act. | [Section 626.9917(1 Xe), Fla. Stat (2001)] COUNT If 13. The allegations contained in paragraphs 1 and 2 are hereby realleged and fully incorporated by reference. 14. | Documentation in BENEFITS" file for J.F H_ of Harrison, Tennessee included, among other things, an application by J.F.H. for coverage with Commercial Union Life Insurance Company of America dated December 9, 1996 (“Commercial Union Application”). 15 On the Commercial Union Application, J.F.H. answered “No” to the question “Has any person proposed for coverage consulted, been diagnosed, or been treated by any physician or other practitioner for, or had any known or suspected heart attack, stroke, cancer, Apr-7+2005 01:26pm = From- - _. Usfaiséous Lée ag epowardou LOBAL SOMVvVILes rane Pansy r smo a, ad diabetes, high blood pressure, immune deficiency disorder, AIDS, or AIDS related complex (ARC)?" 16. Commercial Union Life Insurance Company of America issved @ policy to JF H. with an effective date of December 16, 1996 (“Commercia) Union Policy”). 17 Documentation in BENEFITS’ file for J -F.H included, among other things, a BENEFITS Application dated April 14, 1999. 18 The BENEFITS Application indicated that J.F.H. had been diagnosed HIV positive in March of 1995. 19. BENBETTS attempted to broker the Commercial Union Policy with Future First Financial Group. 20 BENEEITS knew or should have known, or believed or should have believed, that J.F.H. may have procured the Commercial Union Policy by fraudulent means. IT IS THEREFORE CHARGED that you, BENEFITS, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department which constitutes grounds for the revocation or surrender of your non-resident viatical settlement broker and appointments, and eligibility for licensure or appointment: (a) Has engaged in fraudulent or dishonest practices, or otherwise has been shown to be untrustworthy or incompetent to act as a Viatical] settlement broker. [Section 626 9917(1)(b), Fla. Stat (1999)] COUNT I 21 ‘The allegations contained in paragraphs 1 and 2 are hereby realleged and fully incorporated by reference. Apr-07-2005 01:27pm = From= 93/31/2085 Iei4ay souauraun: Leos senvews 822 P 006/014 we w a 32. Decumentation in BENEFITS’ file for B.T B., of Decatur, Georgia included, among other things, an application by BT B. for coverage with American Heritage Life Insurance Corspany dated January 14, 1997 or 1998 (“American Heritage Application”). 23. On the American Heritage Application, BT B. answered “No” to the question “Has any person to be insured ever had, been treated for, or been told by a member of the medical profession they have: b. Acquixed Immune Deficiency Syndrome (AIDS), AIDS related complex (ARC), or ever tested positive for antibodies or antigens to any AIDS virus?” 24. American Heritage Life Insurance Company issued a policy to B.T B. (“American Heritage Policy”). ‘ 25. Documentation in BENEFITS’ file for B.T B included, among other things, 8 BENEFITS Application dated February 24, 1998 26. The BENEFITS Application indicated that BT B had been diagnosed HIV positive in May of 3991. 27. BENEFITS attempted to broker the American Heritage Policy with Future First Financial Group 28. BENEFITS knew or should have known, or believed or should have believed, that B TB. may have procured the American Heritage Policy by fraudulent means. IT IS THEREFORE CHARGED that you, BENEFITS, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department which constitutes grounds for the revocation or sutrender of your non-resident viatical settlement broker and appointments, and eligibility for licensure or appointment: (a) Has engaged in fraudulent or dishonest practices, or otherwise has been shown fo be untrustworthy or incompetent to act as a viatical settlement broker. (Section 626.991 7( 3)(b), Fla, Stat (1997). Apr-O7-2008 Of:27pm = From T7622 P.97/014 = Fe870 Ga7 gifs cous 0.™“2 SweNors oy LEUVHe SOV LLCS rao. [" we \, COUNT IV 29. Theallegations contained in paragraphs 1 and 2 are hereby realleged and fully incorporated by reference. 30. Documentation in BENEFITS’ file for B.T B. also included, among other things, an application by B.T B. for coverage with United Presidential Life Insurance Cornpany dated April 21 or 22, 1998 (“United Presidential Application”). 31. Om the United Presidential Application, B T.B answered “No” to the question “In the past 10 years has any proposed insured: Been diagnosed or treated by a member of the medical profession for an immune deficiency disorder or AIDS?” 32. United Presidential Life Insurance Company issued a policy to B.T B. (“United Presidential Policy’). 33. Documentation in BENEFITS’ file for B.T.B. included, among other things, a BENEFITS Application dated February 24, 1998 34. The BENEFITS Application indicated that B. T.B. had been diagnosed HIV positive in May of 1991. 35. | BENEFITS attempted to broker the United Presidential Policy with Future First Financial Group. 36. | BENEFITS knew or should have known, or believed or should have believed, that B.T.B may have procured the United Presidential Policy by fraudulent means IT IS THEREFORE CHARGED that you, BENEFITS, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department which constitutes grounds for the revocation or surrender of your non-resident Viatical settlement broker and appointments, and eligibility for licensure or appointment: Apr-97=2005 01:27pm = From 7-622 P.008/014 F370 oapaareuas sgeve Beutel ee IEW bet V resce Ww Ww (a) Has engaged in fraudulent or dishonest practices, or otherwise has been shown to be untrustworthy or incompetent to act as a viatiea) settlement broker. [Section 626.9917(1}(2), Fla. Stat. (1997))- COUNT V 37. The allegations contained in paragraphs | and 2 are hereby realleged and fully incorporated by reference. 38. Documentation in BENEFITS’ file for P.C B. of Atlanta, Georgia included, among other things, an application by P.C B. for coverage with Dixie National Life Insurance Company dated February 8, 1996 (“Dixie National Application”). 39 — Onthe Dixie National Application, P CB answered “No” to the question “Have you been diagnosed by a member of the medical profession as having Acquired Immune Deficiency Syndrome (AIDS)?” 40. Dixie National Tate pours Company issued a policy to P.C B, with an effective date of Febmary 21, 1998 (Dixie Natsona! Policy”) 4\ Documentation in BENEFITS' file for P-C.B included, among other things, 2 BENEFITS Application dated February 3, 1998. 42. The BENEFITS Applicaton indicated that P.C.B. had been diagnosed HIV positive. 43. BENEFITS attempted to broker the Dixie National Policy with Future First Financial Group. 44. | BENEFITS knew or should have known, or believed or should have believed, thet P C.B. may have procured the Dixie National Policy by fraudulent means. IT IS THEREFORE CHARGED that you, BENEFITS, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Apr-O7-2005 01:27pm = From T-622 P.008/0:4 F-370 me wer ere eee wee ee ee Lore, Yuet rae WY Ne Department which constitutes grounds for the revocation or surrender of your non-resident viatical settlement broker and appsintments, and eligibility for licensure or appointment: (a) Has engaged in fraudulent or dishonest practices, or otherwise has been shown to be untrustworthy or incompetent to act as 8 viatical settlement broker. [Section 626.9917(1)(b), Fla. Stat (1997)]. Cc T Vi 45. The allegations contained in paragraphs | and 2 are hereby realleged and fully incorporated by reference. 46. During the on-site examination of BENEFITS, the Department requested to see twenty-four (24) specific files (“Specific Files”) 47. BENEFITS did not make the Specific Files available to the Department for examination, as required by § 626.9922(2) and (4), Fla. Stat, (2004). 48. In aJune 2, 2004 letter, the Department requested copies of seventeen (17) of the Specific Files (“Requested Files”). 49 BENEFITS, through their legal counsel, stated that BENEFITS was unable to provide copies of the Requested Files to the Department because the Requested Files were not in BENEFITS’ possession, but rather were in the possession of the Federaj Bureau of Investigation (FBI) 50. The FBI returned copies of all files it seized to BENEFITS prior to February 4, 2004 WHEREFORE, you, BENEFITS, are hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking your licenses and appointments as a non- resident viatical settlement broker and impose such penalties as may be provided under the provisions of Sections 626 9917 and 626.9918, Florida Statutes, and under the other referenced Apr-07-2005 O1:27pm = From- T8622 P.O10/014 = F370 2a als coun 40.49 evospr ou Lous. 26RVieLo rau J \, wd a sections of the Florida Statutes as sct 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 Cade. NOTICE OF RIGHTS You have the right to request a proceeding to contest this action by the Department purguant 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 atached Election of Proceeding form and/or a petition for administrative hearing will suffice as a written xequest. The request must be filed with the General Counsel as acting Agency Clerk, at the Florida Departnent of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Your written response mus! 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 bearing. 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 tequirements. Specifically, your response mnust contain: (a) | The name and address of the party making the request, for purpase of service; (b) A staternent that the party is requesting a hearing involving disputed issues of material fact, or a hearing not involving disputed issues of material fact; and Apr-O7-2008 01:28pm = From= T6822) P.ONI/014 = F-370 S usyyelrcoua 19.49 OVUM EWI LOG ServiloS PAGE [:] om id A reference to the notice, order to show cause, administrative complaint, or other (c) communication that the party has received from the agency Ifa 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 wil] 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 natice shall be deemed abandoned unless timely rencwed in compliance with the guidelines as set out above 10 Apr-07-2005 01:28pm = From - q __ b4ussly zeus ibias youdd sas LEGAL SERVICES me ee on 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 Depactment of Financial Services. DATED and SIGNED this SDA day of Manel, 200s CHANDLER ~ Deputy Chief Financial Officer ll Apr=07=2005 01:28pm = From- T-622,-P.013/014 83/31/2885 16:43 BSQdR7496 LEGAL SERVICES PAGE - wo CERTIFICATE OF SERVIC: I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING have been furnished to BENEFITS, by stricted U S. Certified Mail, at the addresses identified in the Service List this) day of r VIDA bby > 2005. Robert Alan Fox Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4106 Service List: BENEFITS AMERICA, N.A., INC , ab/a LIFE BENEFITS AMERICA, N.A. , INC., through its President, Herbert R. Buffington 415 East Paces Ferry Road, N.E. Terrace Level} Atlanta, Georgia 30305-3306 BENEFITS AMERICA, N A , JNC., W/b/a LIFE BENEFITS AMERICA, N.A., INC., through its Registered Agent, Corporation Service Company 1201 Hays Street Tallahassee, Florida 3230! F370 12

Docket for Case No: 05-001665