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Department Home | Agent and Agency Home | Insurance Insights Home

  Vol. 8, No. 5 -September 2019

Case Notes

Case: An investigation was opened after a complaint was received alleging the agent did not forward policy premiums to an insurance company.

Department investigators attempted to conduct an agency inspection. Upon arrival at the address of record, investigators found a vacant tract of land. The agent was contacted and told investigators the agency was recently moved.

A new business location for the agency was submitted to the Department and investigators went to that location. The location was an attorney's office. The attorney told investigators the agent had just rented space in the office and pointed to a desk. There were no signs or any other indication of an active agency location.

Investigators contacted the agent asking him to bring records to the Bureau's field office for inspection. The agent made several appointments to produce the records but failed to meet with investigators. Investigators were unable to substantiate the allegation which opened the investigation as the consumer failed to provide proof of the premium payment.

Disposition: License administratively surrendered. Agent cannot reapply for a license for two years from date of the surrender.


Case: The Department initiated an investigation on a nonresident general lines agent and agency based upon a complaint from the Florida Workers Compensation Joint Underwriting Association (FWCJUA) regarding applications that the subject had submitted for coverage through them.

The documentation included a sworn, notarized complaint with supporting documentation alleging the subject submitted two applications for the same company which contained false, inaccurate, or misleading information. The complainant also alleged the subject failed to provide required voluntary market declination documents and attempted to collect an "Earned Broker Fee" of $1,050 from the applicant through a premium finance agreement.

The Department obtained records from a premium finance company and multiple insurance companies the subject was appointed to represent. It was discovered that other fees were charged to the insureds in addition to the premium. The fees were frequently listed as broker fees and ranged from $100 to $950. Affidavits were obtained from several of the insureds who stated they either knew about the fee and paid in order to obtain the coverage or did not realize an additional fee had been added to their premium. All of the polices provided coverage for commercial exposures.

During the course of the investigation, evidence determined that while designated as the agency's agent in charge, the subject allowed unlicensed agents to transact insurance business with Florida insureds.

Disposition: The agent entered into a Settlement Stipulation for Consent Order suspending his license for six months. An Administrative Penalty was assessed on the agency license in the amount of $5,000. In addition, the subject paid restitution to the affected insureds for the additional fees charged in the amount of $4,250.


Case: An investigation was opened after the Department received a complaint from a consumer of possible unlicensed public adjusting activity by a roofing contractor.

Department Investigators spoke with residents from the neighborhood who were approached by the contractor to replace their roof due to "hurricane damage". A review of the roofing contract found an Assignment of Benefits embedded in the roofing contract, giving the contractor the right to benefits from the claim. Investigators contacted the insurer and learned the complainant's claim was settled prior to signing the roofing contract and no policy proceeds were paid to the contractor. The contractor's website did include information about the insurance claims process, but there was no evidence this roofing contractor was acting as a public adjuster.

Disposition: Administrative action was not taken because the contractor's activities did not include activities which require a license.

Read our compliance article on this topic: Industry Warning: Contractors


 

 

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