Pa ad rule i OS FEB 28 PH 4:37. FILED ADMINISTRATIVE : P HEARINGS > ALEX SINK NOV 29 2007 CHIEF FINANCIAL OFFICER STATE OF FLORIDA ce . Bonieted by AP ee OK 10e KPL v ” IN THE MATTER OF: CASE NO.: 92326-07-AG TAMMY L. LAYTON ADMINISTRATIVE COMPLAINT TO: TAMMY L. LAYTON 2820 SANDY RIDGE ROAD GULF BREEZE, FL 32561 You, TAMMY L. LAYTON, license I.D. #D052891, are hereby notified that the Chief Financial Officer of the State of Florida has 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, TAMMY L. LAYTON, are currently licensed in this state as a life including variablé annuity agent and a health agent. 2. Atall time pertinent to the dates and occurrences referred to herein, you, TAMMY L. LAYTON, were licensed in this state as a life including variable annuity agent and a health agent. 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (“Department”) has jurisdiction over your insurance license and appointments. COUNTI 4. The above general allegations are hereby realleged and fully incorporated herein by reference. 5. On November 4, 2005, you, TAMMY L. LAYTON, sold D.R. a hospital supplement policy with Combined Insurance Company. The cost of the policy was twenty ($20.00) dollars per month. . 6. On November 4, 2005, you, TAMMY L. LAYTON, went-to D.R.’s home to obtain a check for the first month’s premium, and to obtain a signed automatic premium payment agreement from S.R., D.R.’s wife, because D.R.’s name was not on the checking account. 7. 8.R. wrote a check in the amount of $20.00 to Combined Insurance Company and gave the check to you, TAMMY L. LAYTON. . 8. After obtaining the check from S.R., you, TAMMY L. LAYTON, wrote, or allowed there to be written, two (2) insurance policy numbers on the check without S.R.’s knowledge or consent. . 9. You, TAMMY L. LAYTON, submitted, or allowed to be submitted, to Combined Insurance Company a health insurance application for S.R. without S.R.’s consent, knowledge, or true signature. IT iS THEREFORE CHARGED that you, TAMMY L. LAYTON, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department which constitute grounds for the suspension or revocation of your licenses and appointments: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]. tw (b) 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(6), Florida Statutes]. (c) 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}. (d) False statements and entries. Knowingly: 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]. COUNT IL 10. The above general allegations, and paragraphs 5-9 are hereby realleged and fully incorporated herein by reference. 11. On November 4, 2005, S.R. signed an automatic premium payment agreement, permitting the withdrawal of one policy premium totaling $20.00 dollars per month, and gave the automatic premium payment agreement to you, TAMMY L. LAYTON. 12. You, TAMMY L. LAYTON, altered, or allowed to be altered, the automatic premium payment authorization form that S.R. had signed to permit the withdrawal of two policy premiums totaling $40.00 dollars per month without S.R.’s knowledge or consent. 13. You, TAMMY L. LAYTON, fraudulently submitted an altered bank authorization form to Combined Insurance Company. IT IS THEREFORE CHARGED that you, TAMMY L. LAYTON, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the. Department which constitute grounds for the suspension or revocation of your licenses and appointments: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]. (b) 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(6), Florida Statutes]. (c) 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]. . (d) _‘ False statements and entries. Knowingly: 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]. WHEREFORE, you, TAMMY L. LAYTON, 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, 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, and Rule 28-106, 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 acting as 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 Depariment no jater 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 SUSPENSION OR REVOCATION WILL BE ENTERED AGAINST YOU. , If you request a proceeding, you must provide information that complies with the requirements of Rule 28-106.2015, 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, address, and telephone number, and facsimile number (if any) of the respondent (for the purpose of requesting a hearing in this matter, you are the "respondent"). (b) The name, address, telephone number, facsimile number of the attorney or qualified representative of the respondent (if any) upon whom service of pleadings and other papers shall be made. (c) A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. (d) A statement of when the respondent received notice of the administrative complaint. | (e) A statement including the file number to the administrative complaint. 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 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. “") Oe aie, ; DATED and SIGNED this eA ey day of firemen » 2007. ). L)n ar 7 i 4 — MZ KAREN CHANDLER Deputy Chief Financial Officer CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been furnished to: TAMMY L. . LAYTON, at 2820 Sandy Ridge Road, Gulf Breeze, FL, 325 61; by Certified Mail this ae day of Mov em ber _,2007. Robert Alan Fox Senior Attorney Department of Financial Services Division of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4227

Docket for Case No: 08-001068PL