Findings Of Fact The Respondent is, and at all times applicable to these proceedings was, a licensed health and accident insurance agent licensed by National States Insurance Company. In order to become a licensed Florida insurance agent, the Respondent was required to become familiar with the provisions of the Florida Insurance Code and pass an exam given by the Department of Insurance. The Respondent is familiar with the provisions of the Florida Insurance Code applicable to insurance agents. On or about May 4, 1989, Respondent visited the home of Forrest and Viola DePeugh in Englewood, Florida. The DePeughs had sent in a "lead card" to the Respondent's company requesting information on insurance. While visiting the DePeughs, the Respondent asked to see their existing insurance policies. The DePeughs showed the Respondent three insurance policies, all of which were Medicare Supplement policies. The DePeughs had policies from American Sun, AARP, and Old Southern Insurance Company. 5. The Respondent attempted to explain to the DePeughs how their existing coverages would work and how the policy offered by the Respondent's company, National States, was different from the insurance policies the DePeughs had already purchased. Mr. DePeugh had a difficult time understanding the difference in the coverages offered by the various policies. The Respondent tried to explain that the Old Southern policy would pay 100 percent of the Medicare allowable charges, up to the actual amount of the-physician's charges, while the National States policy would pay 200 percent of the Medicare allowable charges, up to the actual amount of the physician charges. While the Respondent was explaining the differences between the policies, Mr. DePeugh was told by the Respondent that the insurance agent who had sold the DePeughs the Old Southern policy, Richard Stetsky, would never have sold them something that did not pay the actual bill. Stetsky had told them that he had been with Old Southern for seven or eight years. When Mrs DePeugh told the Respondent that Stetsky had been with Old Southern for seven or eight years, the Respondent told the DePeughs that the Respondent personally knew that Stetsky had not worked for Old Southern for that length of time because Stetsky had worked with the Respondent at the same agency, Diversified Health Services, only three or four years ago. The Respondent told Mr. DePeugh that if.Stetsky had told them he had worked for Old Southern for seven or eight years, Stetsky was not telling them the truth. Although there was conflicting testimony, the evidence did not prove that the Respondent told the DePeughs that Stetsky was a "thief" or a "crook". During his sales call with the DePeughs, the Respondent showed the DePeughs a copy of the BESTS rating guide, an industry reference which rates the financial performance of insurance companies. The Respondent informed the DePeughs that Old Southern had a BESTS' rating of "C", while the company the Respondent represented, National States, had a BESTS' rating of "A". The Respondent attempted to explain to the DePeughs the difference between an "A" and a "C" rating. The Respondent also told the DePeughs that they could check the ratings of insurance companies at the public library. Mr. DePeugh called the Department of Insurance after the Respondent left, and the Department stated that Old Southern had experienced financial difficulties in the past, but that the company was now in good standing. The evidence did not prove that the Respondent told the DePeughs that Old Southern was "bankrupt" or that Old Southern was a "no good" company. The Respondent did not take an insurance application from the DePeughs. The Respondent did not accept any money from the DePeughs. The Respondent did not tell the DePeughs to cancel any of their existing insurance coverages. The Respondent's sales approach bothered Mrs. DePeugh, and she thought that the Respondent "should have sat down and talked sensibly." The purpose of Mrs. DePeugh's complaint against the Respondent was to make him talk to elderly people in a "more polite fashion" and to "change his attitude to the way he talks to the elderly." If the Respondent had been a "gentleman", Mr. DePeugh believes that he and his wife possibly would have "bought some insurance off of him." Like his wife, the main basis of Mr. DePeugh's complaint against the Respondent was "his attitude". There was no evidence that the Respondent failed to comply with a proper order or rule of the Department of Insurance.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Petitioner, the Department of Insurance, enter a final order dismissing the Administrative Complaint against the Respondent, Stephen Todd Daggett, in this case. RECOMMENDED this 25th day of April, 1990, in Tallahassee, Florida. J. LAWRENCE JOHNSTON Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 25th day of April, 1990. APPENDIX TO RECOMMENDED ORDER, CASE NO. 89-5712 To comply with the requirements of Section 120.59(2), Florida Statutes (1989), the following rulings are made on the parties' proposed findings of fact: Petitioner's Proposed Findings of Fact. 1.-6. Accepted and incorporated to the extent not subordinate or unnecessary. Rejected as not proven. Accepted but unnecessary. Rejected as not proven. Accepted but unnecessary. Accepted but subordinate to facts not proven and contrary to those found, and also unnecessary. Respondent's Proposed Findings of Fact. 1.-14. Accepted and incorporated to the extent not subordinate or unnecessary. 15. Irrelevant and unnecessary. COPIES FURNISHED: Nancy S. Isenberg, Esquire Department of Insurance Division of Legal Services Room 412, Larson Building Tallahassee, FL 32399-0300 Thomas W. Stahl, Esquire Newell & Stahl, P. A. 817 North Gadsden Street Tallahassee, FL 32303 Wayne O. Smith, Esquire Wayne O. Smith, P. A. 5420 Central Avenue St. Petersburg, FL 33707 Tom Gallagher State Treasurer and Insurance Commissioner The Capitol, Plaza Level Tallahassee, FL 32399-0300 Don Dowdell, Esquire General Counsel Department of Insurance and Treasurer The Capitol, Plaza Level Tallahassee, FL 32399-0300 =================================================================
Findings Of Fact On or about May 19, 1989, Viola DePeugh filed a complaint with the Department of Insurance, Bureau of Consumer Services, stating that the Petitioner, a licensed health and accident insurance agent for National States Insurance Company, visited the DePeugh home on or about May 4, 1989, and: tried to intimidate her and her husband; stated that the insurance agent who had sold them their Old Southern policy was "a crook and a liar" and not licensed by the Department; and stated that Old Southern had gone bankrupt and was about to go bankrupt again. The Respondent investigated the DePeugh complaint to the extent of interviewing the DePeughs and obtaining sworn written statements from them. Viola DePeugh's sworn written statement reiterated her May 19, 1989, complaint to the Department. She stated that the Petitioner had reviewed the DePeughs' Old Southern insurance policy, had stated that Old Southern had been bankrupt once before and was going bankrupt again, and had stated that her Old Southern agent was a "crook." Her husband, Forrest DePeugh, gave a sworn written statement that he had been present at the time of the Petitioner's statements to his wife and that he could verify his wife's statements. Besides the interviews with the DePeughs and their sworn written statements, the Department did not further investigate the DePeugh complaint. On or about September 21, 1989, the Respondent filed an Administrative Complaint charging the Petitioner with violations of parts of Chapter 626, Florida Statutes, based on the DePeugh allegations. The Administrative Complaint charges essentially that, in order to induce the DePeughs to change from their Old Southern policy to a policy the Petitioner was selling, the Petitioner falsely represented to the DePeughs that Old Southern Insurance Company had been in bankruptcy and was about to go bankrupt again and that the DePeughs' insurance agent was "a crook." The Administrative Complaint was referred to the Division of Administrative Hearings for a formal administrative proceeding and was assigned Case No. 89-5712. The Petitioner's defense to the Administrative Complaint was that he did not make the statements attributed to him, not that the statements were true. The Recommended Order in Case No. 89-5712 found that the Department did not prove by clear and convincing evidence that the DePeugh allegations were true. A Final Order dismissing the Administrative Complaint was entered on or about June 21, 1990. At the time of its filing on or about September 21, 1989, the Administrative Complaint against the Petitioner had a reasonable basis in law and in fact. If the DePeughs testified in accordance with Viola DePeugh's written complaint and sworn written statement, their testimony would have been legally sufficient to sustain the charges in the Administrative Complaint notwithstanding the Petitioner's denial of the charges. It was simply a case of the DePeughs' word against the Petitioner's word. There were no other witnesses, and there was no reason for the Respondent to think that further investigation would have uncovered extrinsic evidence that would support the Petitioner's denial of the charges or impeach the credibility of the DePeughs. Under these circumstances, it was not unreasonable for the Respondent to file the Administrative Complaint against the Petitioner.
The Issue Whether Respondent, a licensed insurance agent, committed the offenses alleged in the Administrative Complaint and the penalties, if any, that should be imposed.
Findings Of Fact At all times material to this proceeding, Respondent has been licensed as a general lines insurance agent (2-20), a life and health insurance agent (2-18), and a health insurance agent (2-40). In June 2000, the statewide prosecutor filed an information against Respondent in the Circuit Court in and for Orange County, Florida, where it was assigned Case No. CR-0-00- 9771/A. The information charged that Respondent was guilty of organized insurance fraud involving $50,000 or more in violation of Section 817.034(4)(a), Florida Statutes, which is a first degree felony and a crime involving moral turpitude. Simon Blank, an investigator employed by Petitioner's Division of Insurance Fraud, participated in the investigation that culminated in the charges being filed against Respondent. Respondent cooperated with Mr. Blank's investigation and candidly answered questions that were put to him. On July 31, 2001, Respondent entered a plea of nolo contendere to the charges against him. At Respondent's plea hearing the prosecutor summarized the facts he expected to be able to prove, including the fact that Respondent engaged in fraudulent activity involving workers' compensation insurance.2 Thereafter, Respondent stipulated that there was a factual basis for his plea. The Court accepted Respondent's plea, but withheld adjudication of guilt. The Court sentenced Respondent to two days in jail with credit for time served and placed him on probation under the supervision of the Florida Department of Corrections for a period of ten years. Respondent was ordered to perform 100 hours of community service and to pay restitution in the total amount of $16,179.00, which included the costs of investigation. As a condition of his probation, Respondent was ordered not to write or renew any policy of workers' compensation for a period of five years. Prior to the filing of the Administrative Complaint against him, Respondent had not notified Petitioner in writing that he had entered a plea of nolo contendere to the criminal charges that had been filed against him. Respondent has been the owner of A Maples Insurance Agency in Pompano Beach, Florida, since 1987. Consistent with his probation, Respondent no longer writes or renews workers' compensation insurance. At the time of the final hearing, Respondent was current with his continuing education classes. Respondent has not been convicted of a felony or a misdemeanor. Respondent testified that his plea in the criminal proceeding was a plea of convenience and that he could not afford to contest the charges. Respondent did not believe the plea would lead to the suspension of his license because the suspension of his license was not a condition of his probation. He mistakenly believed that the entry of his plea in the criminal proceeding would resolve all issues with the Petitioner since Petitioner participated in the investigation of the case. Respondent testified that his attorney said he had received something from the Department of Insurance that gave reason to believe that they already knew about the plea. That correspondence was not admitted into evidence and Respondent's self-serving testimony was not corroborated. Respondent's license was previously disciplined in Case No. 93-L-222JDM, which involved allegations of misappropriation of funds. Petitioner's records reflect that Respondent was placed on probation for one year as a result of that proceeding.
Recommendation Based on the foregoing findings of fact and conclusions of Law, it is RECOMMENDED that Petitioner enter a final order that finds Respondent guilty of violating Section 626.611(14), Florida Statutes, as alleged in Count I of the Administrative Complaint, and guilty of violating Section 626.621(11), Florida Statutes, as alleged in Count II. It is further RECOMMENDED that the final order suspend Respondent's licensure for a period of 24 months for the Count I violation, and for a period of three months for the Count II violation. It is further RECOMMENDED that the final order provide that the periods of suspension shall run concurrently. DONE AND ENTERED this 20th day of February, 2002, in Tallahassee, Leon County, Florida. CLAUDE B. ARRINGTON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 20th day of February, 2002.
Findings Of Fact Based upon the testimony of the witnesses and the documentary evidence received at the hearing, the following findings of fact are made: Currently the Respondent is eligible for licensure and is licensed in Florida as a life and health agent. At all times material to the allegations of this case, the Respondent was eligible for licensure and licensed as a life and health agent and a general lines agent. At all times material to the allegations of this case, the Respondent was employed by Lewis C. Webb and served as an authorized sales agent for Allstate Insurance Company. During his employment with Allstate, Respondent received premium payments from insurance applicants and policy holders. Contrary to company policy, Respondent did not immediately remit premium payments to the insurer. During the period March 6, 1989 through July 14, 1989, the Respondent received approximately $4700.00 from Allstate customers but failed to remit the monies to the company. On or about July 19, 1989, the Respondent executed a statement which provided, in part: "I am authorized by the Company to accept both cash and checks from Allstate customers. I understand I am required to submit the money from customers daily." The statement also listed specific monies which Respondent acknowledged he had received. Those monies totalled $4255.65. At the time Respondent gave the statement described above, he tendered $500.00 and the paperwork related to those monies to Mr. Webb. Further, Respondent acknowledged that he had a drug and alcohol abuse problem which had limited his ability to timely complete the paperwork associated with the premiums received. Respondent offered to remit all monies owed to Allstate at that time (on or about July 19, 1989). Subsequently, Respondent completed a drug and alcohol treatment program and is currently employed by Ken Dimond & Associates, Inc. selling both life and health insurance.
Recommendation Based upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED that the Department of Insurance and Treasurer enter a final order finding the Respondent, Robert Henry Jones, guilty of violating Section 626.621, Florida Statutes, and suspending his license and eligibility for licensure for a period of six months. DONE AND ENTERED this 17 day of January, 1991, in Tallahassee, Leon County, Florida. Joyous D. Parrish Hearing Officer Division of Administrative Hearings 1230 Apalachee Parkway Tallahassee, Florida 32301 (904)488-9675 Filed with the Clerk of the Division of Administrative Hearings this 17 day of January, 1991. APPENDIX TO CASE NO. 90-5029 RULINGS ON THE PROPOSED FINDINGS OF FACT SUBMITTED BY THE PETITIONER: Paragraphs 1 through 3 are With regard to paragraph 4 it is accepted as a correct statement of the statement executed by Respondent; however, Respondent's explanation has been deemed creditable as to the monies not remitted in a timely and appropriate manner. It is accepted that Respondent attempted to repay the monies owed to Allstate. RULINGS ON THE PROPOSED FINDINGS OF FACT SUBMITTED BY THE RESPONDENT: Paragraph 1 is accepted. Paragraph 2 is rejected as contrary to the weight of the evidence. Paragraphs 3 through 7 are accepted but are irrelevant. Paragraphs 8 through 13 are accepted. COPIES FURNISHED: Robert Henry Jones 1054 Revilla Lane Rockledge, Florida 32955 Willis F. Melvin, Jr. Division of Legal Services 412 Larson Building Tallahassee, Florida 32399-0300 Hon. Tom Gallagher State Treasurer and Insurance Commissioner The Capitol--Plaza Level Tallahassee, Florida 32399-0300 Don Dowdell General Counsel Department of Insurance and Treasurer The Capitol--Plaza Level Tallahassee, Florida 32399-0300
The Issue The issue for consideration in this hearing was whether Respondent's license as a life and health debit agent and a general lines, (fire), agent should be disciplined because of the matters alleged in the Administrative Complaint filed herein.
Findings Of Fact At all times pertinent to the issues herein, the Petitioner, Department of Insurance, was the state agency responsible for the licensing of commercial insurance sales agents and the regulation of the insurance industry and profession in Florida. Respondent, Doyle Carlton Newell, was licensed in Florida as a life and health (debit) agent and a general lines agent limited to industrial fire. On April 26, 1991, Respondent entered into an agency contract with United Insurance Company of America, (United), which authorized him to sell authorized insurance policies for the company in Florida within his assigned territory. The terms of the agency contract obligated Respondent to remit to the company, on a weekly basis, all premium money collected by him on the company's behalf. For reasons not stated, United terminated Respondent from employment on May 11, 1992 by use of company form 38A, and Respondent's agency contract was cancelled immediately. The termination was followed by an audit of Respondent's account because for some time, company management had had some concern as to the condition of those accounts. Respondent had admitted to improperly taking money belonging to the company, and the audit was conducted during the period immediately following his termination in May, 1992 through August, 1992. Either prior to or as a part of the audit, Respondent submitted a list of all discrepancies he could recall. The audit revealed an actual deficiency of $3,731.67. After application of the bond submitted by and on behalf of Respondent, the ultimate shortage was $3,257.67. Respondent had, the day he left employment with the company, indicated he would reimburse it for any shortage when he overcame some personal matters and gambling problems. After the exact amount was determined, he was again asked, both orally and, several times through certified mail, to satisfy the obligation but as of the date of hearing, he had made no payments. All policies written by Respondent were honored by the company regardless of the fact he had not remitted the premiums paid therefor.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is, therefore: RECOMMENDED that a Final Order be entered finding Respondent guilty of all misconduct and violations alleged except that relating to a lack of knowledge or technical competency, and revoking his license as an insurance agent in Florida. RECOMMENDED this 23rd day of June, 1994, in Tallahassee, Florida. ARNOLD H. POLLOCK, Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 23rd day of June, 1994. COPIES FURNISHED: William C. Childers, Esquire Division of Legal Services 612 Larson Building Tallahassee, Florida 32399-0222 Doyle Carlton Newell 8414 Waterford Avenue, T3 Tampa, Florida 33604 Doyle Carlton Newell 2106 Two Lakes Road, Apartment 2T Tampa, Florida 33604 Doyle Carlton Newell 13637 Twin Lakes Lane Tampa, Florida 33624 Doyle Carlton Newell American General Life and Accident Insurance Co. 802 West Waters Avenue Tampa, Florida 33604 Tom Gallagher State Treasurer and Insurance Commissioner The Capitol, Plaza Level Tallahassee, Florida 32399-0300 Bill O'Neil General Counsel Department of Insurance The Capitol, PL-11 Tallahassee, Florida 32399-0300
