EILED JAN 11 2018 Docketed by CHIEF FINANCIAL OFFICER A TRONIS STATE OF FLORIDA IN THE MATTER OF: ° CASE NO.:205384-17-AG JAMES EDWARD MASON AD ISTRATIVE COMPLAINT James Edward Mason . 1550 East Court St. #10 Kankakee, [llinois 60901 James Edward Mason 1 509 North Vermilion #527 Danville, Illinois 60901 James Edward Mason (“Respondent”), license LD. #A308530, is hereby notified that pursuant to chapter 626, Florida Statutes, the Chief Financial Officer of the State of Florida has caused to be made an investigation of his activities while licensed as a non-resident life and health agent and a non-resident life including variable annuity and health agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1, Pursuant to chapter 626, Florida Statutes, Respondent is currently licensed in this state as a non-resident life and health agent and a non-resident life including variable annuity and health agent, 2. At all times pertinent to the dates and occurrences referred to herein, Respondent was licensed in this state as a non-resident life and health agent and a non-resident life including variable annuity and health agent. , 3. Pursuant to chapter 626, Florida Statutes, the Florida Department of Financial Services ("Department") has jurisdiction over Respondent's insurance licenses and __ appointments, . be 4, Respondent maintained appointments with United Health Care Insurance Company (“United”) from on or about February 25, 2016 until December 22, 2016, when Respondent’s appointments were cancelled by United, 5. Respondent maintained appointments with Time Insurance Company (“Time Insurance”) from on or about November 20, 2013 until April 28, 2016, when Respondent’s appointments were terminated by Time Insurance. Ci TI 6. The above general allegations are hereby realleged and fully incorporated herein by reference. 7. On or about February 22, 2016, Respondent digitally submitted three insurance applications purportedly on behalf of alleged consumer Lawrence Conley (“L.C.”). 8. Respondent entered L.C.’s home address as 3200 Gulf Shore Boulevard North, Naples, Florida 34103. ' 9. On or about July 8, 2016, a Department investigator sent a consumer contact letter to Lc. at L.C.’s home address, . 10. On or about July 27, 2016, the United States Postal Service returned the letter to the Department as “not deliverable as addressed, unable to forward.” 11. The Respondent knew or should have known that mail sent to L.C.’s address would be returned to the sender. 12. Respondent entered L.C.’s email address as larry.conley2000@aol.com. 13. On July 8, 2016, a Department investigator sent a consumer contact letter to L.C. at larry.conley2000@aol.com. 14. __ The email was returned as undeliverable. 15, The Respondent knew or should have known emails sent to the email address for L.C, would be retumed as undeliverable, 16. Respondent entered L.C.’s social security number as ***-**.#*** 17. The number was in fact the social security number for a different person who lived at a different address from the address Respondent had entered for L.C.’s application. 18. Respondent knew or should have known the social security number to be incorrect. . 19, Respondent entered L.C.’s payment information with First Financial Bank as routing number XXXXX0910 and account number KXXXX3334, 20. The routing number was a valid ACH Routing number. 21, The account number information was declined on or about March 31, 2016, 22. Respondent knew or should have known the account number information would — be declined. 23. In exchange for submitting the three applications purportedly on behalf of L.C., Respondent received $1,508.28 in advanced commissions from United or Integon Indemnity Corporation (“Integon”), the underwriting company for the policies. 24. Respondent owes United or Integon at least $1,256.89 in unearned advanced commissions. IT IS THEREFORE CHARGED that Respondent has violated one or more of the following provisions of the Florida Statutes, which constitutes grounds for the suspension or revocation of his licenses and appointments: Department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew the license or appointment of any insurance agent if it finds that the licensee violated any provision of the Florida Insurance Code or any other law applicable to the business of insurance in the course of dealing under the license or appointment. b. Section 626,621(6), Florida Statutes, which provides, in relevant part, the Department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew the license or appointment of any insurance agent if it finds that the licensee, in the conduct of business under the license or appointment, engaged in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part IX of chapter 626, or having otherwise shown himself or herself to be a source of injury or loss to the public. c, Section 626.611(1)(g), Florida Statutes, which provides, in relevant part, itisa violation for any insurance agent to demonstrate a lack of fitness or trustworthiness to engage in the business of insurance. . ; d. Section 626.611(1)(h), Florida Statutes, which provides, in relevant part, it is a violation for any insurance agent to demonstrate a lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment, 4 a, ___, Section 626,621(2), Florida Statutes, which provides, in relevant part, the €. Section 626.611(1)(), Florida Statutes, which provides, in relevant part, it isa violation for any insurance agent to be involved in fraudulent or dishonest practices in the conduct of business under the license or appointment. . f. Section 626.611(1)(), Florida Statutes, which provides, in relevant part, itisa violation for any insurance agent to misappropriate, convert, or unlawfully withhold any moneys r to others and received belonging to. under the license or appointment. COUNT II 25. | The above general allegations are hereby realleged and fully incorporated herein : by reference. 26. Onor about February 14, 2016, Respondent digitally submitted three insurance applications purportedly on behalf of alleged consumer Jadam Fatore (“J.F.”). 27, Respondent entered J.F.’s home address as 131 Bristol Lane, Naples, Florida 34101, 4 28. Onor about July 8, 2016, a Department investigator sent a consumer contact letter to J.F. at J.F.’s home address. . 29, Onor about July 22, 2016, the United States Postal Service returned the letter to the Department as “attempted- not known, unable to forward.” a 30, The Respondent knew or should have known that mail sent to J.F.’s address would be returned to the sender. 31, Respondent entered J.F.’s email address as jlfatore]9671968@att.net, 32. On July 8, 2016, a Department investigator sent a consumer contact letter to LF. at jlfatore 19671968 @aitt.net. etof business 33. The email was returned as undeliverable. 34, The Respondent knew or should have known emails sent to the email address for _ JF, would be returned as undeliverable. 35, Onor about February 14, 2016, Respondent entered J.F.’s payment information, 36. Onor about February 20, 2016, the payment information was declined. _ .,. 37, Respondent knew or should have known the payment information would be declined, 38. In exchange for submitting the three applications purportedly on behalf of J.F., Respondent received $733.22 in advanced commissions from United or Integon, the underwriting company for the policies. 39. _ Respondent owes United or Integon $733.22 in unearned advanced commissions. IT IS THEREFORE CHARGED that Respondent has violated one or more of the following provisions of the Florida Statutes, which constitutes grounds for the suspension or - revocation of his licenses and appointments: a. Section 626.9541(1)(ee), Florida Statutes, which provides, in relevant part, itis a violation to willfully submit to an insurer on behalf of a consumer an insurance application or policy-related document bearing a false or fraudulent signature. b. Section 626.9541(1)(k)1, Florida Statutes, which provides, in relevant part, itisa — violation to knowingly make 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, CG Section 626.9541(1)(e), Florida Statutes, which provides, in relevant part, it is a violation to knowingly make, publish, disseminate, or circulate any false material statement. It is also a violation to deliver to any person a false material statement. d. Section 626.621(2), Florida Statutes, which provides, in relevant part, the Department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew the license or appointment of any insurance agent if it finds that the licensee violated any _ provision of the Florida Insurance Code or any other law applicable to the business of insurance in the course of dealing under the license or appointment, e. Section 626.621(6), Florida Statutes, which provides, in relevant part, the Department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew the license or appointment of any insurance agent if it finds that the licensee, in the conduct of business under the license or appointment, engaged in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part IX of chapter 626, or having otherwise shown himself or herself to be a source of injury or loss to the public, f. Section 626.611(1)(g), Florida Statutes, which provides, in relevant part, it is a ~ violation for any insurance agent to demonstrate a lack of fitness or trustworthiness to engage in the business of insurance. g. Section 626.611(1)(), Florida Statutes, which provides, in relevant part, itis a violation for any insurance agent to be involved in fraudulent or dishonest practices in the conduct of business under the license or appointment. ~ COUNTIN 40. The above general allegations are hereby realleged and fully incorporated herein by reference, 4 41, Onor about February 8th and 15th, 2016, Respondent digitally submitted a total of two insurance applications purportedly on behalf of alleged consumer Phillip Schroeder (*P.S."), Oo . 42, Respondent entered P.S,’s home address as 372 South 6th Street, Naples, Florida 34102, 43. Onor about July 8, 2016, a Department investigator sent a consumer contact letter to P.S, at P.S.’s home address. 44, On or about July 13, 2016, the United States Postal Service returned the letter to the Department as “not deliverable as addressed, unable to forward.” 45. The Respondent knew or should have known that mail sent to P.S.’s address would be returned to the sender, . 46. Respondent entered P.S.’s payment information with Regions Bank as routing number XXXXX4668 and account number XXXXX0856. 47, - The routing number was & valid ACH Routing number. 48, The account number information was declined on or about March 11, 2016, 49, Respondent knew or should have known the account number information would be declined, , 50. In exchange for submitting the two applications purportedly on behalf of P.S., Respondent received $253.62 in advanced commissions. IT IS THEREFORE CHARGED that Respondent has violated one or rhore of the following provisions of the Florida Statutes, which constitutes grounds for the suspension or revocation of his licenses and appointments: a, Section 626,954 1(1)(ee), Florida Statutes, which provides, in relevant part, it isa violation to willfully submit to an insurer on behalf of a consumer an insurance application or policy-related document bearing a false or fraudulent signature. b. Section 626,954 1)! , Florida Statutes, which provides, in relevant part, it is a violation to knowingly make 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. c. Section 626.9541(1)(e), Florida Statutes, which provides, in relevant part, it is a violation to knowingly make, publish, disseminate, or circulate any false material statement. It is also a violation to deliver to any person a false material statement, ‘ d. Section 626.621(2), Florida Statutes, which provides, in relevant part, the Department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew the license or appointment of any insurance agent if it finds that the licensee violated any provision of the Florida Insurance Code or any other law applicable to the business of insurance in the course of dealing under the license or appointment, e, Section 626.621(6), Florida Statutes, which provides, in relevant part, the Department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew the license or appointment of any insurance agent if it finds that the licensee, in the conduct of business-under the license or appointment, engaged in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part IX of chapter 626, or having otherwise shown himself or herself to be a source of injury or loss to the public, f. Section 626.611(1)(g), Florida Statutes, which provides, in relevant part, it is a violation for any insurance agent to demonstrate a lack of fitness or trustworthiness to engage in the business of insurance. . g. Section 626.611(1)(i), Florida Statutes, which provides, in relevant part, itisa violation for any insurance agent to be involved in fraudulent or dishonest practices in the conduct of business under the license or appointment. WHEREFORE, Respondent is hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking his 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, 626,641, 626.681, and 626.691, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. 2018. Gregory Thomas, Director Division of Insurance Agent & Agency Services 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 a petition for administrative heating are required, 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"). 1 (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 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, . Ifa 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 during the time frame in which you have to request a hearing. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Administrative Complaint and Election of Proceeding has been furnished to James Edward Mason at 1550 East Court Street #10, Kankakee, Illinois, 60901 and at 509 North Vermilion #527 Danville, Illinois 60901 by USPS Certified Mail this day of A » 2018 . Chase E, Den Beste Florida Bar Number 126075 Assistant General Counsel Department of Financial Services Office of the General Counsel 200 East Gaines Street Tallahassee, Florida 32399-0333 Phone Number: (850) 413-4265 Fax Number: (850) 487-4907

Docket for Case No: 18-001398PL