iB FLORIDA DEPARTMENT OF FINANCIAL SERVICES TOM GALLAGHER F I L E D CHIEF FINANCIAL OFFICER STATE OF FLORIDA JUN 27 2906 e) IN THE MATTER OF & if TTB Dooketed by CCA or SHELLY JENSENMOORE CASE NO.: 85276-06-AG / ADMINISTRATIVE COMPLAINT TO: SHELLY JENSEN MOORE ; ., 195 Royal Palm Drive O (, vl G Pl- Ponte Vedra Beach, Florida 32082 y SHELLY JENSEN MOORE State Insurance Agency, Inc. 408 S. Ponce De Leon Blvd. Saint Augustine, Florida 32084 YOU, SHELLY JENSEN MOORE, 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, you, SHELLY JENSEN MOORE, license identification number A183595, are currently licensed in this state as a general lines (2- 20) insurance agent. 2. At all times pertinent to the dates and occurrence referred to herein, you, SHELLY » JENSEN MOORE, were licensed in this state as a general lines (2-20) insurance agent. 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services has jurisdiction over your insurance licenses and appointments. 4. During all times material to the allegations contained in this administrative complaint you, SHELLY JENSEN MOORE, operated as an insurance agent at State Insurance Agency located at 408 S. Ponce De Leon Boulevard, Saint Augustine, Florida 32084, and served as President of Mawman & Moore, Inc. 5. At all times pertinent to the allegations of this complaint, you, SHELLY JENSEN MOORE, were the President of Mawman & Moore, Inc. dba State Insurance Agency, and acted as de facto primary agent therein even though no primary agent filing has been made with the Department of Financial Services. 6. As the primary agent for State Insurance Agency, and President of Mawman & Moore, Inc., you, SHELLY JENSEN MOORE, knew or should have known of the activities of employees under your direct supervision and control and you were responsible and accountable for all of the activities of the staff at the agency location described above for the times and occurrences as hereafter presented. References to you, SHELLY JENSEN MOORE, include persons acting under your direct supervision and control at the State Insurance Agency location described above. 7. Pursuant to section 626.734, Florida Statutes, “Any general lines insurance agent who is an officer, director, or stockholder of an incorporated general lines insurance agency shall remain personally and fully liable and accountable for any wrongful acts, misconduct, or violations of any provisions of this code committed by such licensee or by any person under his or her direct supervision and control while acting on behalf of the corporation. Nothing in this section shall be construed to render any person criminally liable or subject to any disciplinary proceeding for any act unless such person personally committed or knew or should have known Ne of such act and of the facts constituting a violation of this chapter.” 8. As president of State Insurance Agency, you, SHELLY JENSEN MOORE, exercised direct supervision and control over employees and agents of State Insurance Agency, including Heather Shugart, and Theresa Hartley. COUNT I 9. The above General Allegations numbered one through seven are hereby realleged and fully incorporated herein by reference. 10. On August 9, 2004, Mr. Kenneth Dean went to State Insurance Agency to purchase automobile insurance. Theresa Hartley handled Mr. Dean’s transaction on behalf of State Insurance Agency, and placed Kenneth Dean with Mercury Insurance Company. At that time and place, Mr. Dean made an initial down payment of $324.00 to Theresa Hartley. 11. The paperwork which Kenneth Dean was given to sign included enrollment forms to Great South Direct Auto Services, Inc. auto club (“Great South”), Mr. Dean inquired as to whether he needed this coverage to which Theresa Hartley replied that it was, “part of the program.” | 12. Mr. Dean was willfully misled to believe that the Great Southern membership was part of his auto insurance and did not include an additional charge. 13. This misrepresentation was made both orally and by means of the premium receipt that included the Great South membership in the total “premium” listed for insurance coverage. 14. Kenneth Dean was charged an additional $60.00 for the Great South auto club without his knowledge or consent. 15. You, SHELLY JENSEN MOORE, signed Kenneth Dean’s application for insurance from Mercury Insurance Company dated August 10, 2004. IT IS THEREFORE CHARGED that you, SHELLY JENSEN MOORE, 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 licenses and appointments as a property and casualty insurance agent: (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 1(13), Florida Statutes]; (d) 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 permit. [Section 626.621(2), Florida Statutes]; (e) 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 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]; . () No person shall engage in this state in any trade practice which is defined in this part as, or determined pursuant to s. 626.951 or s. 626.9561 to be, an unfair method of competition or an unfair or deceptive act or practice involving the business of insurance. [Section 626.9521, Florida Statutes]; (g) 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]; (bh) Knowingly making, publishing, disseminating, circulating, or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public: 1. In a newspaper, magazine, or other publication, 2. In the form of a notice, circular, pamphlet, letter, or poster, 3. Over any radio or television station, or 4, In any other way placing before the public an advertisement, announcement, or statement containing any assertion, representation, or statement with respect to the business of insurance, which is untrue, deceptive, or misleading. [Section 626,9541(1)(b), Florida Statutes]; (i) 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 faise material statement. [Section 626.9541(1)(e)1., Florida Statutes]; q) 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, or tending to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on, or convert any insurance policy or to take out a policy of insurance in another insurer. [Section 626.9541(1)(1), Florida Statutes]; dd Sliding is the act or practice of: 1. Representing to the applicant that a specific ancillary coverage or product is required by law in conjunction with the purchase of motor vehicle insurance when such coverage or product is not required; N Representing to the applicant that a specific ancillary coverage or product is included in the motor vehicle policy applied for without an additional charge when such charge is required; or 3. . Charging an applicant for a specific ancillary coverage or product, in addition to the cost of the motor vehicle insurance coverage applied for, without the informed consent of the applicant [Section 626.9541(1)(z), Florida Statutes]; COUNT II 16. The above listed general allegations are hereby realleged and incorporated herein by reference. . 17. On or about October 7, 2002, Sandra Kee went to State Insurance Agency to purchase automobile insurance. Mrs. Kee paid $606.00 for a new auto policy. The premium payment was collected by one of your, SHELLY JENSEN MOORE’S, employees at the State Insurance Agency. 18. Sandra Kee was signed up for a membership in Nations Safe Drivers auto club (“Nations Safe”) on October 7, 2002. Nations Safe contract number 126 43230 2594 does not clearly indicate the fee for the auto club and does not contain the name of the agent who sold it. 19. Neither the receipt or application disclose the Nation Safe contract number 126 43230 2594 as a separate contract. 20. Mrs. Kees did not know, nor was she informed, that the Nation Safe contract was a separate contract from that of her auto insurance, or that it was an optional and non-required product. 21. Mrs. Kees would not have purchased the membership had she known it was an optional product costing her approximately $60.00. 22, This misrepresentation was made both orally and by means of the premium receipt that included the Nation Safe membership in the total “premium” listed for insurance coverage. 23. | You, SHELLY JENSEN MOORE, signed Mrs. Kee’s application for insurance dated October 7, 2002. IT IS THEREFORE CHARGED that you, SHELLY JENSEN MOORE, 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 licenses and appointments as a property and casualty insurance agent: Section 626.61 1(7); Section 626.611(9); Section 626.611(13); Section 626.621(2); Section 626.621(6); Section 626.9521; Section 626.9541(1)(a)1.; Section 626.9541(1)(b); Section 626.9541(1)(e)1.; Section 626.9541(1)(); and Section 626.9541(1)(Z), Florida Statutes, as more particularly described under Count I above. COUNT IT 24, The above listed general allegations are hereby realleged and incorporated herein by reference, 25. On or about April 14, 2003, Sandra Kee went to State Insurance Agency to again purchase automobile insurance. Agent Heather Shugart wrote Mrs. Kee’s policy. - 26. Sandra Kee paid $280.00 as a premium down payment and the funds were collected and received by State Insurance employee, Heather Shugart. State Insurance Agency receipt number 14673 indicates the amount paid by Mrs. Kee and is signed by Heather Shugart. 27. The Nation Safe Driver contract number 195077 for Mrs. Kee is dated April 15, 2003. 28. Mrs. Kee was led to believe this Nation Safe membership was part of her auto insurance contract, and that she had to purchase the membership. Mrs, Kee would not have purchased the membership had she known it was an optional product costing her approximately $60.00. 29. This misrepresentation was made both orally and by means of the premium receipt that included the Nation Safe membership in the total “premium” listed for insurance coverage. 30. You, SHELLY JENSEN MOORE, signed Mrs. Kee’s application for auto insurance dated April 15, 2004. ; ITIS THEREFORE CHARGED that you, SHELLY JENSEN MOORE, 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 licenses and appointments as a property and casualty insurance agent: Section 626.61 177); Section 626.611(9); Section 626.611(13); Section 626.621(2); Section 626.621(6); Section 626.9521; Section 626.9541(1)(a)1.; Section 626.9541(1)(b); Section 626.9541(1)(e)1.; Section 626.9541(1)(1); and Section 626.9541(1)(z), Florida Statutes, as more particularly described under Count I above. COUNT IV 31. The above listed general allegations are hereby realleged and incorporated herein by reference. 32. On or about October 3, 2003, Sandra Kee went to State Insurance Agency to again purchase auto insurance. 33. Agent Theresa Hartley sold the auto insurance to Mrs. Kee. Mrs. Kee paid $269.28 as a premium down payment for the policy. “34, Agent Theresa Hartley issued State Insurance Agency receipt number 28783 dated October 3, 2003. 35. The State Insurance Receipt does not disclose the Great South auto club membership fee as a separate contract. Theresa Hartley told Mrs. Kee that the auto club membership was part of her auto insurance policy. Mrs. Kee did not know the membership was a separate contract and was misled to believe that it was required. 36. The Great South membership application for Mrs. Kee was signed by Theresa Harley. The contract provided Mrs. Kee with duplicate towing coverage of that sold to her in a prior contract with Nation Safe auto club (#195077) and written by State Insurance Agency employee, Heather Shugart. 37. This misrepresentation was made both orally and by means of the premium receipt that included the Great South membership in the total “premium” listed for insurance coverage. 38. Mrs. Kee would not have purchased the Great South membership had he know that it was an optional product costing her $60.00. IT IS THEREFORE CHARGED that you, SHELLY JENSEN MOORE, 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 licenses and appointments as a property and casualty insurance agent: Section 626.611(7); Section 626.611(9); Section 626.611(13); Section 626.621 (2); Section 626.621(6); Section 626.9521; Section 626.9541(1)(a)1.; Section 626.9541(1)(b); Section 626.9541(1)(e)1.; Section * 626.9541(1)(1); and Section 626.9541(1)(Z), Florida Statutes, as more particularly described under Count I above. COUNT V 39. The above listed allegations are hereby realleged and incorporated herein by reference. 40. On March 19, 2003, Yvonne Enfinger went to State Insurance Agency to purchase a general liability policy for her painting business. Mrs. Enfinger met with you, SHELLY JENSEN MOORE, to purchase a policy. You, SHELLY JENSEN MOORE, collected an advanced premium payment of $470.00 from Mrs. Enfinger to start her general liability policy to be issued by Nova Casualty Company. 41, You, SHELLEY JENSEN MOORE, signed Yvonne Enfinger’s application for commercial liability insurance on March 19, 2003. 10 42, You, SHELLY JENSEN MOORE, issued a receipt number 15944, and dated March 19, 2003. 43. Nova Casualty Company policy number 09AL053479 is dated March 20, 2003. The policy shows an advanced premium paid by Yvonne Enfinger in the amount of $400.00, This amount is $70 less than the actual sum collected by you, SHELLY JENSEN MOORE, from Yvonne Enfinger. 44, Yvonne Enfinger was not aware that she purchased a Nation Safe Driver Travel Benefit Plan from you, SHELLY JENSEN MOORE. 45, You, SHELLY JENSEN MOORE, misrepresented to Yvonne Enfinger what she was purchasing. This misrepresentation was made both orally and by means of a receipt that included the Nation Safe membership in the total “premium” listed for insurance coverage. 46. You, SHELLY JENSEN MOORE, deceived Yvonne Enfinger by not making her aware that she was purchasing a Nation Safe membership or that the membership was an optional product. 47. Yvonne Enfinger would not have purchased the Nation safe membership had she known it was an optional product costing approximately $70.00. IT IS THEREFORE CHARGED that you, SHELLY JENSEN MOORE, 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 suspension or revocation of your licenses and appointments as a general lines (2-20) agent: Section 626.611(7); Section 626.611(9); Section 626.611(13); Section 626.621(2); Section 626.621(6); Section 626.9521; Section 626.9541(1)(a)1; Section 626.9541(1)(b); Section 626.9541(1)(e)1; Section 626.954(1)(1); and Section 626.9541 (1)(z), Florida Statutes, as more particularly described under Count I above. COUNT VI 48. The above general allegations are hereby realleged and fully incorporated herein. 49. You, SHELLY JENSEN MOORE, as President of Mawman & Moore, Inc. dba State Insurance Agency established a business practice requiring State insurance Agency representatives to charged $15.00 fees for endorsing customers’ policies, and $1.00 fees for accepting cash payments. 50. You, SHELLY JENSEN MOORE, approved these fees being charged by employees of State Insurance Agency, namely Theresa Hartley and Heather Shugart, over whom you had supervision, IT IS THEREFORE CHARGED that you, SHELLY JENSEN MOORE, have violated or are accountable under the provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for suspension or revocation of your licenses and appointments: (a) Knowingly collecting any sum as a premium or charge for insurance, which is not then provided, or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an insurance policy issued by an insurer as permitted by this code. (b) Knowingly collecting as a premium or charge for insurance any sum in excess of or Jess than the premium or charge applicable to such insurance, in accordance with the applicable classifications and rates as filed with and approved by the office, and as specified in the policy; or, in cases when classifications, premiums, or rates are not required by this code to be so filed and approved, premiums and charges collected from a Florida resident in excess of or less than those specified in the policy and as fixed by the insurer. This provision shall not be deemed to prohibit the charging and collection, by surplus lines agents licensed under part VIII of this chapter, of the amount of applicable state and federal taxes, or fees as authorized by s. 626.916(4), in addition to the premium required by the insurer or the charging and collection, by licensed agents, of the exact amount of any discount or other such fee charged by a credit card facility in connection with the use of a credit card, as authorized by subparagraph (q)3., in addition to the premium required by the insurer. This subparagraph shall not be construed to prohibit collection of a premium for a universal life or a variable or indeterminate value insurance policy made in accordance with the terms of the contract. [Section 626.9541(1)(0), 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 1(13), Florida Statutes] (d) 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. (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. [Section 626.621(2) (6), Florida Statutes] WHEREFORE, you, SHELLY JENSEN MOORE, 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, 626.692, and 626.9521, 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 Financial Services, 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 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been furnished to: SHELLY JENSEN MOORE, 195 Royal Palm Drive, Ponte Vedra Beach, Florida 32082 and to SHELLY JENSEN MOORE, State Insurance Agency, 408 S. Ponce De Leon Boulevard, Saint Augustine, Florida 32084 by Certified U.S. Mail this 2: ] day of Dung , 2006. Department of Financial Services Division of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4210 Fla, Bar No. 0689793 17

Docket for Case No: 06-002619PL