FLORIDA aN yp DEPARTMENT OF Sy es FINANCIAL SERVICES — — 2» TOM GALLAGHER F j L E D ws . e SPE MGA RTFICER _— JUN 1 2005 IN THE MATTER OF: CASE NO. 81621-05-AG MATTHEW DOUGLAS PILZ Qgoketed by: CU. / ADMINISTRATIVE COMPLAINT DS: ») AC llc Pi TO: MATTHEW DOUGLAS PILZ 12370 5™ Street E. Treasure Island, Florida 33706 MATTHEW DOUGLAS PILZ Humana Marketpoint Ste. 161 5401 W. Kennedy Blvd. Tampa, Florida 33609 You, MATTHEW DOUGLAS PILZ, are hereby notified that pursuant to Chapters 624 and 626, Florida Statutes, 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 that: GENERAL ALLEGATIONS 1. You, MATTHEW DOUGLAS PILZ, are currently licensed in this state as a life insurance agent, as a life including variable annuity agent, life including variable annuity and health insurance agent, life insurance agent, life and health insurance agent and as a health insurance agent. 2. At all times relevant to the dates and occurrences alleged herein, you, MATTHEW DOUGLAS PILZ, were licensed in this state as an insurance agent. 3. Pursuant to Chapter 626, Florida Statutes, the Chief Financial Officer of the State of Florida and the Department of Financial Services has jurisdiction over your insurance licenses and your eligibility for licensure and appointment. COUNT I 4. The above General Allegations numbered one (1) through three (3) are hereby realleged and fully incorporated herein by reference. 5. On or about November 5, 2002, you, MATTHEW DOUGLAS PILZ, visited the home of P.A. of Bradenton, Florida, for the purpose of soliciting the sale of annuities. 6. As of November 5, 2002, P.A. was the owner and policyholder of an Allmerica Financial annuity #PN00469472 with a death benefit of $136,471.00. You, MATTHEW DOUGLAS PILZ had sold this annuity to P.A. in May, 2000. 7. On or about November 5, 2002, you, MATTHEW DOUGLAS PILZ, represented to P.A. that Allmerica Financial was in financial difficulty. You, MATTHEW DOUGLAS PILZ, represented to P.A. that he should withdraw $50,000 from his Allmerica Financial annuity and place it into another annuity to be issued by Allianz Insurance. 8. You, MATTHEW DOUGLAS PILZ, represented to P.A. that the death benefit of the Allmerica annuity would only be reduced by 50,000, the amount of the withdrawal. 9. Based solely upon your representation that his death benefit would only be reduced by $50,000, P.A. withdrew the $50,000 from his Allmerica Financial annuity and purchased the Allianz annuity being solicited by you. The annuity was duly issued. You, MATTHEW DOUGLAS PILZ, received a commission. 10. The representations made by you, MATTHEW DOUGLAS PILZ, to P.A. were false and a material misstatement of fact. The withdraw of his $50,000 from the Allmerica Financial annuity resulted in a reduction in the death benefit of approximately $99,000, to approximately $41,000. You, MATTHEW DOUGLAS PILZ, were aware or certainly should have been aware of this fact. 11. You, MATTHEW DOUGLAS PILZ, failed to disclose to P.A. that withdrawal of $50,000 from his annuity would reduce the death benefit by $99,000. You, MATTHEW DOUGLAS PILZ, expressly represented that the death benefit would only reduced by $50,000. P.A. would not have withdrawn the funds if he had been made aware of the reduction in the death benefit, thereby reducing the funds available to his heirs. You, MATTHEW DOUGLAS PILZ, were aware or should have been aware of this fact. 12. P.A. would not have knowingly withdrawn the funds and reduced his death benefits except for your misleading and deceptive statements and omissions. As a result, P.A. has suffered a significant financial loss. 13. The misleading and deceptive statements were made for the purpose of obtaining a fee, commission, money or other benefit from an insurance company. IT IS THEREFORE CHARGED that you, MATTHEW DOUGLAS PILZ, have violated or are accountable under the following provisions of the Florida Insurance Code which constitute grounds for the suspension or revocation of your licenses as an insurance agent in the state: (a) 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] (b) 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] (c) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance, [Section 626.611(7), Florida Statutes] (d) 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] (e) Fraudulent or dishonest practices in the conduct of business under the license or appointment. [Section 626.611(9), Florida Statutes] (f) 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] (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] (h) ~~ Violation of any lawful order or rule of the department. [Section 626.621(3), Florida Statutes] qa) 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 X of this chapter, or having otherwise shown himself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes] q) Knowingly making, issuing, circulating, or causing to be made, issued, or circulated, any estimate, illustration, circular, statement, sales presentation, omission, or comparison, which misrepresents the benefits, advantages, conditions, or terms of any insurance policy. [Section 626.9541(1)(a) 1, Florida Statutes] (k) = 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) 1, Florida Statutes] f. Knowingly making any misleading representations or incomplete or fraudulent comparisons or fraudulent material omissions of or with respect to any insurance policies or insurers for the purpose of inducing any person to surrender any insurance policy, or take out a policy of insurance in another insurer. [Section 626.9541(1)(1), Florida Statutes] NOTICE OF RIGHTS Pursuant to Sections 120.569 and 120.57, Florida Statutes and Rule Chapter 28-106, Florida 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 Financial Services. If served by US Mail the Petition or Election should be addressed to the Florida Department of Financial Services 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 32399-0333. 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. If a 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 Section 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 Chapter 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 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. 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 set out above. ot . DATED and SIGNED this 7° day of _ Sine , 2005. Keri (Levels KAREN CHANDLER Deputy Chief Financial Officer CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Administrative Complaint has been furnished by certified United States Mail to: MATTHEW DOUGLAS PILZ, 12370 Sth Street East, Treasure Island, FL 33706; Matthew Douglas Pilz, Humana Marketpoint, st Ste 161, 5401 W. Kennedy Blvd, Tampa, FL 33609 this | day of June. 2005. TC Division of Legal Services 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4124 C, JAMES A. BOSSART, ESQUI 10

Docket for Case No: 05-002346PL