> FILED JUN 26 2013 Docketed by_AXYY1 CHIEF FINANCIAL OFFICER JEFF ATWATER STATE OF FLORIDA IN THE MATTER OF: CASE NO.: 135359-13-AG JOSE ANTONIO CRUZ / ADMINISTRATIVE COMPLAINT JOSE ANTONIO CRUZ 100 W Grant St Apt 5050 Orlando, FL 32806 You, JOSE ANTONIO CRUZ, license I.D. # E077163, 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 a life, health and variable annuity agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 626, Florida Statutes, you, JOSE ANTONIO CRUZ, are currently licensed in this state as a life, health and variable annuity agent. 2. At all times pertinent to the dates and occurrences referred to herein, you, JOSE ANTONIO CRUZ, were licensed in this state as a life, health and variable annuity agent. 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (“Department”) has jurisdiction over your life, health and variable annuity agent license and appointment(s). COUNT I 4. The above general allegations are hereby realleged and fully incorporated herein by reference. 5. At all times pertinent to the dates and occurrences referenced in this Administrative Complaint, a contractual relationship existed between you, JOSE ANTONIO CRUZ, and Monumental Life Insurance Company (Monumental). Pursuant to the contract, you were authorized to collect premiums from the policyholders assigned to your agency and to deposit those premiums in Monumental’s designated bank account. 6. . You, JOSE ANTONIO CRUZ, failed to remit all premiums due to Monumental. As a result, your appointment as a licensed agent was terminated by Monumental on February 4, 2011. A final audit after your termination revealed an indebtedness owed by you, JOSE ANTONIO CRUZ, to Monumental of $582.52. 7. These funds represent premium payments for insurance policies issued by Monumental to Florida insurance consumers which you, JOSE ANTONIO CRUZ, failed to remit to Monumental or anyone else so entitled. 8. The above-mentioned funds are trust funds that were received by you, JOSE ANTONIO CRUZ, in a fiduciary capacity only for the insurer. 9. You, JOSE ANTONIO CRUZ, have converted, misappropriated, or wrongfully withheld fiduciary funds belonging to Monumental. 10. On or about August 2, 2011, Monumental contacted you, JOSE ANTONIO CRUZ, to demand the remittal of the fiduciary funds belonging to Monumental. You have refused the demand to remit the fiduciary funds to Monumental. ) ) IT IS THEREFORE CHARGED that you, JOSE ANTONIO CRUZ, have violated or are accountable under the following provisions of the Florida Statutes and/or the Florida Administrative Code, which constitute sufficient grounds for suspension or revocation of your license(s) or appointment(s) as an insurance agent in this State: (a) Section 626.561(1), Florida Statutes, which provides that all premiums, return premiums, or other funds belonging to insurers or others received by an agent in transactions under his license shall be trust funds so received by the licensee in a fiduciary capacity and that 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. (b) —_ Section 626.611(7), Florida Statutes, which provides that it is a violation for any agent, title agency, adjuster, customer representative, service representative, or managing general agent to demonstrate a lack of fitness or trustworthiness to engage in the business of insurance. (c) Section 626.611(9), Florida Statutes, which provides that it is a violation for any agent, title agency, adjuster, customer representative, service representative, or managing general agent to exhibit fraudulent or dishonest practices in the conduct of business under the license or appointment. (d) Section 626.611(10), Florida Statutes, which provides that it is a violation for any agent, title agency, adjuster, customer representative, service representative, or managing general agent to misappropriate, convert, or unlawfully withhold moneys belonging to insurers ot insureds or beneficiaries or to others and received in the conduct of business under the license or appointment. (e) Section 626.621(9), Florida Statutes, which provides that it is a violation of the law for any life insurance agent to violate the life insurance agent Code of Ethics. ) ) WHEREFORE, you, JOSE ANTONIO CRUZ, are hereby notified that the Chief Financial Officer, through his designee, intends to enter an order suspending or revoking any license and appointment issued to you pursuant to the Florida Insurance Code or to impose such penalties as may be provided under the provisions of Sections 626.681, 626.691, and 626.935, 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 Julie Jones, DFS Agency Clerk, at the Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0390. 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. FAILURE TO ENSURE THAT YOUR WRITTEN RESPONSE IS RECEIVED BY THE DEPARTMENT 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 A FINAL 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) Astatement including the file number of the administrative complaint. 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 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 free form 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. DATED and SIGNED this_ 2 day of UWE , 2013. \ ea Gregory Thomas é fo Director, Agent & Agency Services oe, ey eg a eae % Se. rw CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the forgoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been furnished by Certified Mail and/or Electronic Mail to: Jcpasion4life@aol.com; JOSE ANTONIO CRUZ, at 100 W Grant St, Apt 5050, Orlando, FL 32806, by Certified mail this 26 day of _ “Jone , 2013. David J. Busch Assistant General Counsel Department of Financial Services Division of Legal 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4146

Docket for Case No: 13-002905PL