06-004202PL Department Of Financial Services vs. Jack Alexander, Jr.
 Status: Closed
Recommended Order on Friday, June 22, 2007.


View Dockets  
Summary: Clear and convincing evidence was shown on one of three counts against Respondent for failing to inform an insurance customer as to problems associated with her application for homeowner insurance in which she mistakenly thought her home was insured.

1STATE OF FLORIDA

4DIVISION OF ADMINISTRATIVE HEARINGS

8DEPARTMENT OF FINANCIAL )

12SERVICES , )

14)

15Petitioner , )

17)

18vs. ) Case No. 06 - 4202PL

25)

26JACK ALEXANDER, JR. , )

30)

31Respondent . )

34)

35RECOMMENDED ORDER

37A f ormal evidentiary hearing was conducted on March 28,

472007, in Port Charlotte, Florida, before Bram D.E. Canter, an

57Administrative Law Judge of the Division of Administrative

65Hearings (DOAH).

67APPEARANCES

68For Petitioner: David J. Busch, Esquire

74Department of Financial Services

78Division of Legal Services

82612 Larson Building

85200 East Gaines Street

89Tallahassee, Florida 32399 - 0333

94For Respondent: Jed Berman, Esquir e

100Infantino and Berman

103P ost O ffice Box 30

109Winter Park, Florida 32790 - 0030

115STATEMENT OF THE ISSUES

119The issues in this case are whether Respondent is guilty of

130violating provisions of the Florida Insurance Code as charge d in

141Petitioner's Amended Administrative Complaint , and, if so, what

149penalty should be imposed.

153PRELIMINARY STATEMENT

155On September 27, 2006, Petitioner issued a three - count

165Administrative Complaint against Respondent, a licensed

171insurance agent, charging Respondent with mishandling and

178misappropriating the insurance premiums of three customers.

185Respondent disputed the factual allegations of the

192Administrative Complaint , and the matter was referred to DOAH to

202conduct a formal hearing. Petitioner was subse quently granted

211leave to amend its complaint and the Amended Administrative

220Complaint was filed with DOAH on January 23, 2007.

229At the final hearing, Petitioner presented the testimony of

238Anthony Wiley, Annette Wiley, Cecilia Hembree, Vicki Ruggiano,

246and H oward Johnston , Jr . Petitioner's Exhibits 5 through 9, 13

258through 17, 21, 23, 36, and 37 were admitted into evidence. 1

270The undersigned excluded page 31 of Petitioner's Exhibit 15

279on the misunderstanding that page 31 was a cost estimate for

290certain repair work, rather than evidence of actual costs paid

300by one of the insurance customers. In preparing this

309Recommended Order, the undersigned discovered that page 31

317indicates that the costs described were paid (which is further

327supported by testimony) and the document should have been

336admitted along with the other evidence of actual costs paid.

346Therefore, page 31 has now been admitted into evidence.

355Respondent testified on his own behalf and presented the

364testimony of Robert Schmidt and Jack Alexander, Sr. Respondent

373offered no exhibits into evidence.

378The Transcript of the final hearing was filed with DOAH.

388The parties filed Proposed Recommended Orders which have been

397carefully considered in the preparation of this Recommended

405Order.

406FINDINGS OF FACT

4091. P etitioner is the state agency with the statutory

419authority and duty to license and regulate insurance agents.

4282. Respondent holds L icense No. A003228 as a General Lines

439(Property & Casualty 2 - 20) insurance agent in Florida. He first

451received the license in 1998.

4563. Respondent's license has not previously been the

464subject of disciplinary action by Petitioner.

4704. Since receiving his license, Respondent has

477continuously worked as an insurance agent and as a salaried

487employee of Insurance Depot of Charlotte County (Insurance

495Depot), which is located in Port Charlotte, Florida.

5035. Insurance Depot is solely owned and operated by

512Respondent's father, Jack Alexander, Sr. Respondent is n ot a

522co - owner , officer , or director of Insurance Depot.

5316. Among the types of insurance sold by Respondent at

541Insurance Depot is homeowners insurance. The normal procedure

549followed by Respondent when selling homeowners insurance i s to

559first obtain some basic information from the customer about his

569or her home, either over the t elephone or in person; determine

581what insurance company or companies represented by Insurance

589Depot were likely to have the lowest rates for the particular

600type of home; check the rate schedules of the selected

610companies; and give the customer a rate quote .

6197. If the quoted rate is acceptable to the customer, an

630application form i s either filled out by hand or, for some

642insurance companies that provided software application forms,

649the application form i s word - processed on a computer and then

662printed out. The application form is then s igned by Respondent

673and the customer.

6768. The insurance companies represented by Insurance Depot

684require a premium payment , as well as certain additional

693documentation , in order to issue a homeowners ' insurance policy.

703The in surance companies involved in this case require

712photographs of the home to be insured.

7199. The agents at Insurance Depot ask customers to provide

729the photographs, and Insurance Depot has two or three Polaroid

739cameras to lend to customer s who do not have ca meras .

752Petitioner elicited testimony from two insurance company

759representatives that they prefer the photographs to be taken by

769the agents, rather than by the homeowners. Despite this

778preference, the insurance companies routinely accept photographs

785taken by homeowners.

78810. Respondent testified that he always tells the

796prospective customers when he is preparing the insurance

804application form that photographs are needed. That testimony

812was disputed by three witnesses who said they were not asked to

824provid e photographs when t hey met with Respondent at Insurance

835Depot to apply for insurance. Respondent's testimony is more

844persuasive , because it is unlikely that he would fail to ask for

856photographs when they are always needed.

86211. Respondent testified that i f a customer applied for

872insurance and paid a premium, it was his usual practice to turn

884the customer's file over to the clerks in the office for further

896processing, which would include sending the signed application

904form, other documentation, and the pre mium payment to the

914insurance company. In the case of customers who had not yet

925provided photographs or other required information, the

932application was sometimes held until the information was

940submitted by the customer so that the application was complete

950when it was sent to the insurance company . The clerks would

962follow up with the customers to make sure the photographs or

973other information w as submitted. Respondent is not the

982supervisor of the clerks .

98712. How soon coverage is "bound" depends on the

996re quirements or policies of the various insurance companies. In

1006some cases, coverage is bound immediately, but will be cancelled

1016by the insurance company if it does not receive all of the

1028information it requires within a specified time period, such as

103830 da ys. When the insurance is cancelled because the

1048application is incomplete , it is sometimes "flat cancelled,"

1056which means the insurance company does not recognize coverage to

1066ever have been bound.

1070Annette and Anthony Wiley 2

107513. The Wileys live in Arcadia. They went to Insurance

1085Depot on February 6, 2004, to obtain automobile insurance.

1094While they were there, they inquired about insuring their mobile

1104home and were directed to Respondent for assistance.

111214. The Wileys asked Respondent for a rate quote to insure

1123their mobile home for $42,000. The Wileys were satisfied with

1134the rate Respondent quoted for American Reliable Insurance

1142Company (American Reliable). The Wileys gave Respondent $189 as

1151a down payment on the annual premium of $533 , and Respondent a nd

1164Anthony Wiley signed a contract to finance the balance with

1174Duval Premium Budget, Inc. Insurance Depot acts as a gent for

1185the financing company.

118815. Counsel for Respondent points out that no insurance

1197application form for the Wileys was offered into ev idence, but

1208Respondent testified that there "absolutely" was an application

1216prepared for the Wileys , and they did not dispute that there was

1228an application.

123016. When the contract with the financing company was

1239signed, Respondent created a document which c ontained a check

1249("draft") in the amount of $533 made out to American Reliable

1262and Irvin B. Green & Associates (I.B. Green) . I.B. Green is the

1275managing agent for a number of insurance companies, including

1284American Reliable. The document indicates that th e policy

1293number is "Pending." The document is perforated so that it can

1304be divided into three parts: the check and two identical

1314receipts, one for Insurance Depot and the other for the Wileys,

1325showing the draft number, down payment, and policy premium

1334ba lance. The document was never divided. The draft was never

1345sent to American Reliable or I.B. Green.

13521 7 . Respondent told the Wileys he needed photographs of

1363their home to send to the insurance company. Respondent

1372testified that when the Wileys left his office, he put their

1383file "in the pending status on my dad's desk" to await the

1395photographs.

13961 8 . The re is a "Producer Agreement" between I.B. Green and

1409Insurance Depot , which includes a statement that Insurance Depot

1418will "transmit promptly to [I.B. Green ] complete applications

1427and binders for all insurance made along with all premiums,

1437taxes, and applicable expenses or fees required." Petitioner

1445alleged in its Amended Administrative Complaint that Respondent

1453did not forward the Wileys' application and pr emium to I.B.

1464Green in accordance with the Producer Agreement. However,

1472Petitioner 's witness, Howard Johnston, Jr., the executive vice

1481president of I.B. Green, was not asked whether he believed

1491Insurance Depot had violated the requirement in the Producer

1500Agreement for prompt transmission of the complete application in

1509the matter of the Wileys. Mr. Johnston might have considered it

1520to be acceptable under the Producer Agreement for the agents at

1531Insurance Depot to wait until applications were complete befor e

1541transmitting them to I.B. Green.

154619 . Mr. Johnston testified that I.B. Green never received

1556the insurance application or other paperwork for the Wileys.

15652 0 . The Wileys thought their mobile home was insured when

1577they left Insurance Depot on February 6, 2004. They continued

1587to believe they were insured , even though months went by without

1598the ir ever receiving an insurance policy in the mail or a coupon

1611book to make monthly payments to the financing company. They

1621never made another premium payment afte r their down payment.

16312 1 . Mr. Wiley testified that the Wileys did not make

1643another premium payment because "they said not to make a payment

1654right now." 3

16572 2 . Mr. Wiley hand - delivered his car insurance payments to

1670Insurance Depot each month, but when doing so, he never inquired

1681about the status of his home insurance policy.

16892 3 . Mr. Wiley testified that some time in July 2004, five

1702months after the Wileys applied for homeowner insurance, a woman

1712called to ask for photographs of the Wileys' home. A reasonab le

1724inference from the record evidence is that the person who called

1735was one of the clerks at Insurance D epot. 4

17452 4 . The Wileys testified that they took photographs of

1756their home soon after the telephone call , and they took the

1767photographs to Insurance Depo t. Mrs. Riley said Respondent was

1777not in , and she gave the photographs to Robert Schmidt, another

1788insurance agent employed by Insurance Depot, who placed the

1797photographs on Respondent's desk. Mr. Schmidt does not remember

1806seeing Ms. Riley or accepting ph otographs from anyone to give to

1818Respondent.

18192 5 . Hurricane Charley hit Florida on August 13, 2004. It

1831destroyed the Wileys' mobile home. Mr. Wiley testified that

1840they still owed about $45,000 on the mobile home that was

1852destroyed.

18532 6 . After the hurrica ne, the Wileys' went to Insurance

1865Depot to make a claim for the loss of their mobile home. They

1878were informed by Jack Alexander, Sr., that they had no insurance

1889coverage. They did not speak to Respondent.

18962 7 . A Federal Emergency Management Agency (FEMA)

1905representative advised the Wileys to get a written statement

1914from Insurance Depot about their lack of insurance coverage ,

1923which FEMA would use to determine whether the Wileys qualified

1933for federal disaster assistance. Mr. Wiley received a written

1942stateme nt from Jack Alexander, Sr., that states in part:

1952Due to a mix up or miss communication [sic]

1961due to the insurance company never receiving

1968pictures of her home the policy was never

1976bound by the company.

19802 8 . The Wileys received a FEMA grant of $19,000 , w hich

1994they used as a down payment to purchase a new mobile home.

200629 . Jack Alexander, Sr., repaid the Wileys the $189

2016premium down payment they had given Respondent in February 2004.

2026Cecilia Hembree

20283 0 . Cecilia Hembree resides in Port Charlotte and owns her

2040single - family residence.

20443 1 . Ms. Hembree testified that she visited Insurance Depot

2055in December 2003 , and Respondent assisted her in applying for

2065homeowners insurance. Before she left Insurance Depot that day,

2074she paid the annual premium in full wit h a check in the amount

2088of $728.

20903 2 . Ms. Hembree testified that sometime in January 2004,

2101she became concerned when she had not received an insurance

2111policy for her home. She testified that she spoke to

2121Respondent , and he informed her that the policy ha d been mailed

2133to her, but he would mail it again. She never got a copy of the

2148policy in the mail. Respondent was not questioned about the

2158alleged January 2004 conversation with Ms. Hembree.

21653 3 . Neither Respondent nor Ms. Hembree was asked to

2176explain ho w a Federated National Insurance Company (Federated)

2185application form signed by Respondent and Ms. Hembree on

2194February 10, 2004 (Petitioner' Exhibit 23), came into existence.

2203No earlier application was presented. Without an explanation in

2212the record, it is found that Ms. Hembree was mistaken about the

2224date she applied for insurance. She did not apply in December

22352003, but on February 10, 2004. Similarly, it is found that

2246Ms. Hembree was mistaken about calling Respondent in January

22552004 to inquire about her policy. If she made such an inquiry,

2267it must have been after February 10, 2004.

22753 4 . Ms. Hembree testified that Respondent did not ask for

2287photographs of her home on the day she applied for insurance,

2298but she got a call from Respondent "a couple of d ays later" in

2312which he told her that he needed photographs "by the end of the

2325week." Respondent testified that it is his regular practice to

2335ask customers for photographs when he first meets with them ,

2345because photographs are always required by the insura nce

2354companies and that he asked Ms. Hembree for photographs on the

2365first day he met with her. To the extent that it is material,

2378it is found that Respondent asked for photographs at their first

2389meeting.

23903 5 . Ms. Hembree testified that she went to Insuran ce Depot

2403the same day she was asked for the photographs and gave the

2415photographs to Respondent after waiting for him to finish with

2425another customer. Respondent testified that he remembered

2432Ms. Hembree coming into Insurance Depot, waiting for a while,

2442and then leaving without seeing him. He claims she never gave

2453him photographs.

24553 6 . Respondent's testimony on this point is problematic

2465because he saw and recognized Ms. Hembree and should have

2475understood that she was there to give him the photographs he ha d

2488requested. Yet, he did not describe any effort on his part to

2500get the photographs from Ms. Hembree before she left.

2509Furthermore, it is difficult to believe that Ms. Hembree made a

2520trip to Insurance Depot to give Respondent the photographs, but

2530left wit hout giving the photographs to Respondent or asking

2540someone in the office to give them to Respondent or ever

2551returning thereafter with the photographs. Finally, Respondent

2558did not mention the issue of missing photographs in his

2568subsequent discussions with Ms. Hembree that are discussed

2576below. Therefore, it is found that Ms. Hembree provided

2585photographs to Respondent, probably in February 2004.

25923 7 . Unlike American Reliable, Federated had an internet

2602website that its authorized agents could use to prepare

2611applications and generate a declaration page showing the basic

2620terms of coverage. Insurance coverage was bound for Ms. Hembree

2630on February 10, 2004, subject to later cancellation by

2639Federated.

26403 8 . Federated never received the signed application form

2650or Ms. Hembree's check for $728.

265639 . Ms. Hembree did not reconcile her bank statements

2666during this period and did not notice that the check had never

2678come to her bank for payment , and the amount was not deducted

2690from her checking account.

26944 0 . Vicki Ruggi ano, an underwriting supervisor at

2704Federated, testified that when the webpage interface with

2712Federated is used by an agent to generate an application and

2723declaration page, the software system automatically triggers a

2731cancellation notice in 30 days if all r equired documentation has

2742not been received by Federated. Federated issued a Notice of

2752Cancellation of Ms. Hembree's policy on March 9, 2004. The

2762notice indicated "No application/premium received."

27674 1 . Respondent testified that he was never informed ab out

2779Federated's cancellation of Ms. Hembree's policy.

27854 2 . Ms. Hembree testified that on or about March 23, 2004,

2798she noticed that her bank had made a large withdrawal from her

2810checking account to purchase insurance coverage. Ms. Hembree

2818inquired about t he withdrawal , and she was told that the bank

2830purchased insurance for her home because they had no evidence

2840that she had obtained insurance coverage. 5

28474 3 . Ms. Hembree then called Respondent to tell him what

2859the bank told her , and Respondent said he had m ailed the bank

2872proof of coverage, but he would do it again. Ms. Hembree told

2884Respondent she had never received an insurance policy and asked

2894Respondent to "fax" proof of insurance to her and to the bank.

2906Respondent sent her the declaration page for Ms. H embree's

2916Federated policy that he downloaded from the Federated website.

29254 4 . On the same date, Respondent told Ms. Hembree she

2937would have to sign a "no loss statement." Respondent provided

2947Ms. Hembree with a no loss statement form on Insurance Depot

2958l etterhead, which contained a Federated policy number, and the

2968following statement:

2970I, [space provided for insured's name], as a

2978condition precedent to the reinstatement of

2984my policy, state that no losses have

2991occurred for which coverage might be claimed

2998un der my policy between the date of [space

3007provided for a date] and the date and time

3016indicated above.

30184 5 . The no loss statement signed by Ms. Hembree was dated

3031March 23, 2004. However, there was no beginning date filled in

3042on the form. Without a beginni ng date, the no loss statement

3054would seem to be meaningless, unless the absence of a date would

3066be deemed by Federated to cover all possible dates.

30754 6 . When asked why he requested that Ms. Hembree sign a no

3089loss statement, Respondent testified that Feder ated would

3097reinstate a policy if the customer stated that no losses had

3108occurred in the interim. That testimony contradicts

3115Respondent's testimony that on March 23, 2004, he thought

3124Ms. Hembree's policy was still "pending" for lack of

3133photographs. He did not explain why a pending policy would need

3144to be reinstated or why the need for reinstatement was not an

3156indication that the policy had been cancelled. He did not

3166describe any effort he made to inform Ms. Hembree about the

3177continued need for photographs or to solve that alleged problem.

31874 7 . After Hurricane Charley hit on August 13, 2004,

3198Ms. Hembree went to Insurance Depot to ask for an insurance

3209adjuster to view the damage to her home. Ms. Hembree said she

3221talked to a female employee who, after looki ng at Ms. Hembree's

3233file, told Ms. Hembree her insurance company was Federated and

3243gave Ms. Hembree Federated's telephone number. When Ms. Hembree

3252called Federated, she was told she had no insurance coverage.

32624 8 . In August or September 2004, Ms. Hembree called

3273Insurance Depot and spoke to Jack Alexander, Sr. On

3282September 24, 2004, Mr. Alexander prepared an application for

3291Ms. Hembree for coverage by Universal Property and Casualty

3300Insurance Company (Universal). The application indicates that

3307the annual premium was $1,149. Mr. Alexander paid the premium,

3318although it was about $400 more than the premium Ms. Hembree ha d

3331paid for the Federated policy. 6

333749 . Neither Mr. Alexander nor Ms. Hembree said whether

3347Ms. Hembree had to provide new photographs of he r home to send

3360to Universal.

336250. Mr. Alexander testified that when he was confronted by

3372Ms. Hembree about her Federated insurance, he discussed it with

3382Respondent , who told Mr. Alexander that "it was taken care of

3393and should have been in force." Respon dent testified that he

3404was unaware of his father's conversations with Ms. Hembree and

3414that his father had purchased a Universal policy for her.

342451. Ms. Hembree presented invoices showing that she paid

3433$9,576 to repair damage to her home she claimed was c aused by

3447Hurricane Charley.

3449The Palmers

345152. William and Terese Palmer went to Insurance Depot on

3461February 23, 2004, to purchase homeowner insurance for their

3470residence in Port Charlotte. They were assisted at Insurance

3479Depot by Respondent.

348253. Most in surance companies charge a higher premium for

3492insurance on a seasonal residence , because the risk of loss is

3503greater. Mr. Palmer testified that the Port Charlotte residence

3512is now his primary residence, but when he applied for insurance

3523in 2004, he was li ving in McHenry, Illinois, and he told

3535Respondent that the Port Charlotte property was for seasonal

3544use. Respondent denies that he was told that the Port Charlotte

3555residence was only used seasonally by the Palmers. The

3564Federated application form prepared by Respondent and signed by

3573Terese Palmer and Respondent indicates that the insurance was

3582for a primary residence.

35865 4 . One of the documents provided to Respondent at the

3598time the Palmers were applying for insurance was a settlement

3608statement used in con junction with the Palmer's loan from the

3619U.S. Department of Housing and Urban Development to purchase the

3629Port Charlotte residence. It shows the address of Mr. Palmer,

3639the "borrower," as McHenry, Illinois. Petitioner argues that

3647this is proof that Respon dent knew that the Palmers' primary

3658residence was in Illinois and the Port Charlotte residence had

3668to be seasonal. However, the address on the loan form was also

3680consistent with Respondent's belief that the Palmers had

3688purchased the Port Charlotte residen ce to make it their primary

3699residence.

37005 5 . There was no motive for Respondent to falsify the

3712application form by indicating the Palmer s ' residence was

3722primary, rather than seasonal. The application form was signed

3731by M r s. Palmer, attesting to the accura cy of the information on

3745the form. It is found that Respondent either was not told by

3757the Palmers or did not hear them say that the Port Charlotte

3769residence was seasonal.

37725 6 . On the same day they met with Respondent, February 23,

37852004, the Palmers paid the premium of $1,014 by credit card.

3797Admitted into evidence was an Insurance Depot check to

3806Federated, signed by Respondent and dated February 24, 2004, in

3816the amount of $1,014. The Palmer s ' next credit card statement

3829showed the premium was paid.

38345 7 . On March 29, 2004, Federated issued a notice of

3846cancellation of the Palmers' insurance policy. The notice

3854showed the reason for cancellation as "No application/premium

3862received."

38635 8 . Mr. Palmer said he received Federated's notice of

3874cancellation in the mail. He called and informed Respondent,

3883who told Mr. Palmer that "it occasionally happens" and

3892Respondent would "reapply" and the problem would be corrected.

3901The record evidence shows that Federated received a check for

3911the Palmers' insurance premium fro m Insurance Depot by mail on

3922April 5, 2004, but Federated did not accept the payment because

3933the policy had been cancelled. The Palmers were not informed

3943that Federated had not reinstated their insurance policy.

395159 . Subsequently, Mr. Palmer visited Insu rance Depot to

3961inquire about occupational insurance and asked about the

3969deductible provision on his homeowner policy while he was there.

3979The woman he spoke to informed him that she could not find a

3992file on him.

39956 0 . Mr. Palmer then complained to Petition er about the

4007handling of his insurance by Respondent. Following his

4015complaint, Mr. Palmer got a postcard from Insurance Depot

4024requesting that he come in to discuss the problem. When Mr.

4035Palmer went in, Respondent gave him a check to reimburse him for

4047the unused premium payment .

4052CONCLUSIONS OF LAW

40556 1 . DOAH has jurisdiction over the subject matter pursuant

4066to Section 120.569 and Subsection 120.57(1), Florida Statutes . 7

40766 2 . Petitioner must prove the factual allegations in the

4087Amended Administrative Complai nt by clear and convincing

4095evidence. Department of Banking and Finance v. Osborne Stern

4104and Company, Inc. , 670 So. 2d 932 (Fla. 1996); Ferris v.

4115Turlington , 510 So. 2d 292 (Fla. 1987).

41226 3 . The "clear and convincing" evidence standard has been

4133described a s follows:

4137[C]lear and convincing evidence requires

4142that the evidence must be found to be

4150credible; the facts to which the witnesses

4157testify must be distinctly remembered; the

4163testimony must be precise and explicit and

4170the witnesses must be lacking in conf usion

4178as to the facts in issue. The evidence must

4187be of such weight that it produces in the

4196mind of the trier of fact the firm belief or

4206conviction, without hesitancy, as to the

4212truth of the allegations sought to be

4219established.

4220Slomowitz v. Walker , 429 So. 2d 797, 800 (Fla. 4th DCA 1983).

4232The First District Court of Appeal has commented that

"4241[a]lthough this standard of proof may be met where the evidence

4252is in conflict, . . . it seems to preclude evidence that is

4265ambiguous." Westinghouse Electric Corp ., Inc. v. Shuler

4273Brothers, Inc. , 590 So. 2d 986, 988 (Fla. 1st DCA 1991).

42846 4 . The Amended Administrative Complaint charged

4292Respondent with mishandling and misappropriating the insurance

4299premiums of the Wileys, Cecilia Hembree, and the Palmers. In

4309all t hree counts, Petitioner asserts that the alleged acts of

4320Respondent violate Subsections 626.561(1) , 626.611(7) and (10) ,

4327and 626.621(4) and (6), Florida Statutes.

43336 5 . The cited statutes provide as follows:

4342§ 626.561(1)

4344All premiums, return premiums, or other

4350funds belonging to insurers or others

4356received by an agent . . . are trust funds

4366received by the licensee in a fiduciary

4373capacity. An agent . . . shall keep the

4382funds . . . in a separate account so as to

4393allow the department or office to properly

4400au dit such funds.

4404* * *

4407§ 626.611

4409The department shall deny an application

4415for, suspend, revoke, or refuse to renew or

4423continue the license or appointment of

4429any . . . agent . . . if it finds that . . .

4444any one or more of the applicable grounds

4452exist:

4453* * *

4456(7) Demonstrated lack of fitness or

4462trustworthiness to engage in the business of

4469insurance.

4470* * *

4473(10) Misappropriation, conversion, or

4477unlawful withholding of moneys belonging to

4483insurers or insureds or beneficiaries or to

4490others and received in conduct of business

4497under the license or appointment.

4502* * *

4505§ 626.621

4507The department may, in its discretion, deny

4514an application for, suspend, revoke, or

4520refuse to renew or continue the license or

4528appointment of any . . . agent . . . if it

4540finds that . . . any one or more of the

4551following applicable circumstances for which

4556denial, suspension, revocation, or refusal

4561is not mandatory under s. 626.611:

4567* * *

4570(4) Failure or refusal, upon demand, to pay

4578over to any insurer he or she r epresents or

4588has represented any money coming into his or

4596her hands belonging to the insurer.

4602* * *

4605(6) In the conduct of business under the

4613license or appointment, engaging in unfair

4619methods of competition oi in unfair or

4626deceptive acts or practice s, as prohibited

4633under part IX of this chapter, or having

4641otherwise shown himself or herself to be a

4649source of injury or loss to the public.

4657The Wileys

46596 6 . Petitioner claims that Respondent violated Subsection

4668626.561(1), Florida Statutes, by holding on to the Wileys'

4677premium down payment for over six months, during which period

4687the Wileys reasonably believed their mobile home was insured.

46966 7 . In Copeland In s. Agency v. Home Ins. Co. , 502 So. 2d

471193, 95 (Fla. 5th DCA 1987), the court stated:

4720We do not a gree that an intent to

4729misappropriate is a necessary element to

4735prove a violation of section 626.561(1).

4741Liability arises upon a showing that a

4748person has direct supervision and control

4754over an agency and its employees, and that

4762insurance premiums are col lected by the

4769agency, but not accounted for or turned over

4777to the insurance company for whom the agency

4785is acting.

47876 8 . Petitioner presented no evidence that the $189 premium

4798down payment the Wileys gave to Respondent was misused by him or

4810not kept in a separate account. Respondent did not manage,

4820supervise, or have control of the accounts at Insurance Depot.

4830Only Jack Alexander, Sr., exercised such authority at Insurance

4839Depot. Petitioner did not establish that Respondent personally

4847held up the Wiley paperwork or that he was even aware of the

4860delay associated with the Wileys' application.

486669 . Petitioner repeatedly made references to a statement

4875by Jack Alexander, Sr., that once an agent of Insurance Depot

4886starts with a customer, "it's basically their responsibility to

4895finish up with a customer." Petitioner argues that this

4904statement is proof that Respondent had responsibility to obtain

4913any missing documentation that was needed to make the

4922application complete and to keep informed about the status of

4932the application until a policy was issued. However, this single

4942statement by Mr. Alexander is not clear and convincing evidence

4952of the knowledge and willfulness required to prove a violation

4962of Subsection 626.561(1), Florida Statutes . There was evidence

4971to support Respondent's testimony that a common practice of

4980Insurance Depot was to divide tasks between the agents and other

4991employees and that employees other than Respondent were

4999routinely tasked to follow up to obtain missing documentation,

5008to mail appl ications and premiums to the insurance companies,

5018and to deal with cancellation notices. Petitioner cited no

5027statutes, rules, or court decisions that indicate such a

5036practice is unlawful.

50397 0 . With regard to Subsection s 621.611(7) (lack of fitness

5051or tru stworthiness) and 621.611(10) (unlawful withh holding of

5060money), Florida Statutes, Petitioner makes a general argument,

5068applicable to all three counts that:

5074The totality of the evidence suggests not so

5082much simple ignorance or ineptitude, but

5088rather a disho nest practice in the conduct

5096of Respondent's insurance business during

51012004 so as to lie regarding insurance

5108application statements and withhold premium

5113payments from either a company or a

5120customer.

51217 1 . Petitioner did not prove that Respondent lied abou t

5133the Wileys' insurance application.

51377 2 . Willfulness is a necessary element to prove a

5148violation of Subsection 626.611(10), Florida Statutes. Bowling

5155v. Department of Insurance , 394 So. 2d 165, 170 (Fla. 1st DCA

51671981). Petitioner's evidence fell short of clear and convincing

5176evidence that Respondent willfully withheld the Wileys' premium

5184down payment.

51867 3 . Neither party presented the testimony of the clerk at

5198Insurance Depot who called Mr. Wiley and asked for photographs.

5208That testimony would likely have helped to clarify the internal

5218processing of the Wiley application. The evidence in the record

5228only established that Respondent considered the Wiley

5235application incomplete because of the lack of photographs and

5244that he passed the paperwork he had pr epared and the Wileys'

5256premium down payment of $189 to other employees of Insurance

5266Depot for further processing. It would have been commendable if

5276Respondent had kept himself informed about the status of the

5286Wiley application until he ascertained that a policy was issued

5296to them, but his failure to do so does not catapult his actions

5309to proof that he lied to the Wileys or unlawfully withheld their

5321premium. Petitioner failed to prove by clear and convincing

5330evidence the facts necessary to show Respondent violated

5338Subsection 626.611(7) or Subsection 626.611(10), Florida

5344Statutes, with regard to the Wileys.

53507 4 . With regard to Petitioner's claim that Respondent

5360violated Subsection 621.621(4), Florida Statutes, for failing to

5368pay, upon demand by an insurer, money belonging to the insurer,

5379Petitioner failed to prove there was a demand for payment by

5390I.B. Green for the Wileys' premium and a refusal to pay by

5402Respondent. Petitioner argues that the requirement of the

5410Producer Agreement that complete agreements a nd premiums be

5419promptly transmitted to I.B. Green is sufficient to establish

5428the necessary demand. The argument that the Producer Agreement

5437created a continuous "demand" for purposes of establishing a

5446violation of Subsection 621.621(4) , Florida Statutes, is

5453rejected. 8 Furthermore, Petitioner did not establish that I.B.

5462Green would not accept Respondent's practice to trans mit the

5472premium when the application was complete (including

5479photographs) , as compliant with the Producer Agreement.

54867 5 . With regard t o Petitioner's claim that Respondent

5497violated Subsection 621.621(6), Florida Statutes, Petitioner

5503argues that Respondent has shown himself to be a source of

5514injury or loss to the public because the Wileys suffered losses

5525from Hurricane Charley that were no t insured. The record

5535evidence established that the Wiley matter was mishandled by

5544Insurance Depot because the photograph issue was not resolved

5553and the premium down payment was not returned in a reasonable

5564amount of time. 9 However, the evidence was insu fficient to show

5576clearly and convincingly that Respondent was personally

5583responsible for the mishandling.

55877 6 . Mr. Wiley admits that he was told, probably by

5599Respondent, not to make a premium payment , from which it is

5610reasonable to infer that he was told the reason why. Therefore,

5621it is less than clear and convincing that Respondent failed to

5632inform the Wileys that the insurance coverage would not begin

5642until photographs were provided.

5646Cecilia Hembree

564877 . Petitioner claims that Respondent violated Su bsection

5657626.561(1), Florida Statutes, by holding on to Ms. Hembree's

5666premium for months, during which period Ms. Hembree reasonably

5675believed her home was insured.

568078 . Petitioner presented no evidence that Ms. Hembree's

5689$728 premium payment was misused b y Respondent or not kept in a

5702separate account. Respondent did not manage, supervise, or have

5711control of the accounts at Insurance Depot. Only Jack

5720Alexander, Sr., exercised such authority at Insurance Depot.

5728Petitioner did not prove by clear and convin cing evidence that

5739Respondent personally held up Ms. Hembree's paperwork or

5747withheld her premium payment from Federated in violation of

5756Subsection 626.526(1), Florida Statutes.

576079 . With regard to Subsection 621.611(7), Florida Statutes

5769(lack of fitness or trustworthiness) , Petitioner claims that

5777Respondent lied about Ms. Hembree's insurance coverage.

5784Petitioner proved by clear and convincing evidence that

5792Respondent lied to or misled Ms. Hembree about the status of her

5804insurance coverage during their c onversations in March 2004 when

5814she was asking for proof of coverage. The evidence shows

5824clearly that, even under Respondent's version of events, he knew

5834that her coverage had already been cancelled or would be

5844cancelled by Federated , and he failed to inf orm her. He misled

5856her to believe that there was no problem with her coverage when

5868he knew there was a problem. Furthermore, he did not make

5879reasonable efforts to rectify the problem . Respondent failed to

5889act as a fiduciary in his relationship to Ms. He mbree. These

5901actions are a violation of Subsection 626.611(7), Florida

5909Statutes. 10

59118 0 . With regard to Subsection 621.611(10), Florida

5920Statutes (unlawful with holding of money), Petitioner claims that

5929Respondent unlawfully withheld Ms. Hembree's premium p ayment

5937from her or from Federated. Although the evidence shows that

5947Respondent knew in March 2004 that Ms. Hembree's insurance

5956coverage was cancelled or in jeopardy of being cancelled , it

5966appears that he believed her coverage would be reinstated by

5976Federa ted. Petitioner did not prove by clear and convincing

5986evidence that Respondent knew Federated had not received

5994Ms. Wileys' premium and that he willfully withheld the premium

6004in violation of Subsection 626.611(10), Florida Statutes.

60118 1 . With regard to Pe titioner's claim that Respondent

6022violated Subsection 621.621(4), Florida Statutes, for failing to

6030pay, upon demand by an insurer, money belonging to the insurer,

6041Petitioner failed to prove there was a demand for payment by

6052Federated for Ms. Hembree's $728 premium payment and a refusal

6062to pay by Respondent. Petitioner argues that the provision in

6072Federated's Homeowners Manual Underwriting Guidelines for

6078applications and documentation to be submitted within five

6086business days is sufficient to establish the n ecessary demand.

6096The argument that Federated's guidelines created a continuous

"6104demand" for purposes of establishing a violation of Subsection

6113626.621(4), Florida Statutes, is rejected .

61198 2 . With regard to Petitioner's claim that Respondent

6129violated Sub section 626.621(6), Florida Statutes, Petitioner

6136argues that Respondent has shown himself to be a source of

6147injury or loss to the public , because Ms. Hembree suffered

6157losses from Hurricane Charley that were not insured. The record

6167evidence established tha t the Hembree matter was mishandled by

6177Insurance Depot because there was no reasonable explanation for

6186the delay in submitting the required documentation and premium

6195to Federated within 30 days or in not returning the premium to

6207Ms. Hembree. Unlike the si tuation with the Wileys, Respondent

6217was shown to have a personal role in the mishandling of the

6229Hembree matter. Respondent's failure to inform Ms. Hembree of

6238the problem with her coverage in March 2004 or to make

6249reasonable efforts to rectify the problem, was sufficient to

6258show clearly and convincingly that Respondent was a cause of her

6269losses.

6270The Palmers

62728 3 . Petitioner claims that Respondent violated Subsection

6281626.561(1), Florida Statutes, by holding on to the Palmer's

6290premium payment for an unreasona ble period of time, during which

6301period the Palmers reasonably believed their home was insured.

6310However, Petitioner presented no evidence that the $1,014

6319premium payment was misused by him or not kept in a separate

6331account. Respondent did not manage, supe rvise, or have control

6341of the accounts at Insurance Depot. Only Jack Alexander, Sr.,

6351exercised such authority at Insurance Depot. Petitioner did not

6360establish that Respondent personally held up payment of the

6369Palmers' premium to Federated. The evidence shows that when

6378Mr. Palmer told Respondent on or about March 29, 2004, that the

6390insurance had been cancelled, Respondent sent documentation and

6398the premium payment to Federated within a few days. There is no

6410evidence that Respondent knew before March 29, 2004, that the

6420documents had not been sent to Federated and withheld them in

6431violation of Subsection 626.526(1), Florida Statutes.

64378 4 . With regard to Subsection s 621.611(7) (lack of fitness

6449or trustworthiness) and 621.611(10) (unlawful with holding of

6457m oney), Florida Statutes, Petitioner claims that Respondent lied

6466regarding the Palmers' insurance application and withheld the

6474premium payment from either Federated or the Palmers. However,

6483Petitioner did not prove that Respondent lied about the Palmers'

6493i nsurance application and, as explained above, Petitioner did

6502not prove that Respondent willfully withheld the Palmers'

6510premium payment.

65128 5 . With regard to Petitioner's claim that Respondent

6522violated Subsection 621.621(4), Florida Statutes, for failing to

6530pay, upon demand by an insurer, money belonging to the insurer,

6541Petitioner failed to prove there was a demand for payment by

6552Federated for the Palmers' $1,014 premium payment and a refusal

6563to pay by Respondent. The argument that the Federated's

6572guideline s created a continuous "demand" for purposes of

6581establishing a violation of Subsection 621.621(4), Florida

6588Statutes, is rejected.

65918 6 . Petitioner's claim that Respondent violated Subsection

6600621.621(6), Florida Statutes, by showing himself to be a source

6610o f injury or loss to the public must fail because the Palmers

6623had no losses.

6626Summary of Conclusions on Petitioner's Claims

663287 . Except for violat ions of Subsection s 626.211(7) and

6643626.621(6), Florida Statutes, with regard to the Hembree matter,

6652the evidence was insufficient to prove the unlawful acts of

6662Respondent claimed by Petitioner. Clear and convincing evidence

6670against Respondent requires more than clear evidence that

6678someone at Insurance Depot mishandled these insurance matters.

6686The evidence must sho w that it was Respondent. Petitioner's

6696evidence suggests that Respondent might be guilty of other

6705wrongdoing, but the evidence did not to meet the applicable

6715standard of proof on the other claims .

6723The Appropriate Penalt y

672788 . Under the penalty guidelines set forth in Florida

6737Administrative Code Rule 69B - 231.080(7), the penalty for a

6747violation of Subsection 626.611(7), Florida Statutes (lack of

6755fitness or trustworthiness), is suspension of the agent's

6763license for six months.

676789 . U nder the penalty guideline s set forth in Florida

6779Administrative Code Rule 69B - 231. 120 , the penalty for a willful

6791violation of Subsection 626.621(6), Florida Statutes (showing

6798oneself to be a source of injury or loss), is suspension of the

6811agent's license for six months. The penalt y for a non - willful

6824violation is a three - month suspension. Although Respondent

6833misled Ms. Hembree about the status of her insurance coverage,

6843it was not shown that Respondent intended, desired, or expected

6853Ms. Hembree to suffer a loss as a result. Theref ore, the

6865appropriate penalty on this record would be the three - month

6876suspension.

68779 0 . Florida Administrative Code Rule 69B - 231.040(1)(a)

6887limits Petitioner to assessing a single highest penalty for a

6897single count of an administrative complaint , even if sev eral

6907provisions of Section 626.611 or Section 626.621, Florida

6915Statutes , have been violated. Only violations in Count II of

6925the Amended Administrative Complaint were determined by the

6933undersigned . Therefore, the highest penalty that is called for

6943is a si x - month suspension of Respondent's license.

69539 1 . Florida Administrative Code Rule 69B - 231.160

6963identifies aggravating and mitigating factors to be considered

6971in assessing the appropriate penalty. Petitioner argues that

6979the aggravating factors of the willfu lness of the licensee's

6989conduct, degree of potential injury, and motivation (for

6997financial gain) are applicable in this case. Petitioner did not

7007establish a financial motive of Respondent for any of the

7017alleged violations. Because willfulness is already a necessary

7025element of the violation of Subsection 626.611(7) , Florida

7033Statutes ( and there was no unique willfulness shown by the

7044evidence ) , and willfulness was not proven in the case of

7055Subsection 626.621(6), Florida Statutes, this aggravating factor

7062shou ld not be applied . The degree of potential injury was high

7075because of Florida's regular experience with hurricanes.

7082Therefore, this aggravating factor should be applied . A

7091mitigating factor in the rule that is also applicable is

7101Respondent's previous di sciplinary orders or warnings, of which

7110there are none. The aggravating and mitigating factors off - set

7121one another.

71239 2 . Taking into consideration the penalty guidelines and

7133related rules , the appropriate penalty is a six - month suspension

7144of Respondent's license.

7147RECOMMENDATION

7148Based on the foregoing Findings of Fact and Conclusions of

7158Law, it is

7161RECOMMENDED that Petitioner enter a final order suspending

7169Respondent's license for six months .

7175DONE AND ENT ERED this 2 2nd day of June , 2007, in

7187Tallahassee, Leon County, Florida.

7191S

7192BRAM D. E. CANTER

7196Administrative Law Judge

7199Division of Administrative Hearings

7203The DeSoto Building

72061230 Apalachee Parkway

7209Tallahassee, Florida 32399 - 3060

7214(850) 488 - 9675 SUNCOM 278 - 9675

7222Fax Filin g (850) 921 - 6847

7229www.doah.state.fl.us

7230Filed with the Clerk of the

7236Division of Administrative Hearings

7240this 2 2nd day of June , 2007 .

7248ENDNOTES

72491/ Because most of the exhibits were composite exhibits and

7259there were pages of some composite exhibits that we re not

7270admitted, clarification is warranted. The following pages of

7278Petitioner's e xhibits were admitted into evidence: 10 through

728717, 17b through 17j, 18 through 20, 26 through 29, 31b through

729931d, 32 through 35, 43 through 56, 58 through 60, 66, 67, all of

7313Exhibit 36, all pages of the deposition testimony in

7322Petitioner's Exhibit 37, plus pages 42 through 56 of the

7332documents attached to the deposition.

73372/ The Transcript incorrectly shows the name "Wylie "

73453/ Mr. Wiley said the statement was made by Re spondent or his

7358father.

73594/ Mrs. Wiley stated that Mr. Wiley was told about the

7370photographs when he called Insurance Depot to find out why they

7381had not yet received an insurance policy, but that is contrary

7392to Mr. Wileys' testimony.

73965/ It can reasonably be inferred that Ms. Hembree's bank (more

7407specifically, her credit union) was the mortgagee of her home ,

7417and the mortgage contract provided the bank with authority to

7427withdraw funds from her bank account to purchase insurance for

7437the mortgaged home.

74406/ Mr. Alexander thinks he asked Ms. Hembree to reimburse him,

7451but that testimony was not credible.

74577/ A ll citations to the Florida Statutes are to the 2006

7469codification.

74708/ Petitioner argues that it would be "ludicrous" to expect I.B.

7481Green to demand sub mittal of the premium every time a customer

7493purchased insurance. However, the only relevant inquiry is

7501whether I.B. Green demanded the Wiley s' premium and Respondent

7511refused the demand.

75149/ The Wileys, themselves, were not vigilant to protect their

7524own i nterests, but a insurance customer's lack of vigilance does

7535not excuse or diminish the duties imposed on insurance agents by

7546the Florida Insurance Code.

755010/ The circumstances of the Wiley matter are different because

7560there w as not clear and convincing pr oof that Respondent w as

7573aware of a problem with the Wiley file.

7581COPIES FURNISHED :

7584Honorable Alex Sink

7587Chief Financial Officer

7590Department of Financial Services

7594The Capitol, Plaza Level 11

7599Tallahassee, Florida 32399 - 0300

7604Daniel Sumner, General Counsel

7608Department of Financial Services

7612The Capitol, Plaza Level 11

7617Tallahassee, Florida 32399 - 0307

7622David J. Busch, Esquire

7626Department of Financial Services

7630Division of Legal Services

7634612 Larson Building

7637200 East Gaines Street

7641Tallahassee, Florida 32399 - 0333

7646Jed Berman, Esquire

7649Infantino and Berman

7652Post Office Box 30

7656Winter Park, Florida 32790 - 0030

7662NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

7668All parties have the right to submit written exceptions within

767815 days from the date of this Recommended Order. Any except ions

7690to this Recommended Order should be filed with the agency that

7701will issue the Final Order in this case.

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Date
Proceedings
PDF:
Date: 09/06/2007
Proceedings: Agency Final Order
PDF:
Date: 09/06/2007
Proceedings: Final Order filed.
PDF:
Date: 06/22/2007
Proceedings: Recommended Order
PDF:
Date: 06/22/2007
Proceedings: Recommended Order (hearing held March 27, 2007). CASE CLOSED.
PDF:
Date: 06/22/2007
Proceedings: Recommended Order cover letter identifying the hearing record referred to the Agency.
PDF:
Date: 05/30/2007
Proceedings: Proposed Recommended Order filed by Petitioner.
PDF:
Date: 05/29/2007
Proceedings: Respondent`s Proposed Recommended Order filed.
Date: 05/01/2007
Proceedings: Transcript of Proceedings (Volume I and II) filed.
Date: 03/27/2007
Proceedings: CASE STATUS: Hearing Held.
PDF:
Date: 03/23/2007
Proceedings: Petitioner`s Second Supplement to Exhibit Lists filed.
PDF:
Date: 03/22/2007
Proceedings: Petitioner`s Supplement to Exhibit Lists filed.
PDF:
Date: 03/21/2007
Proceedings: Petitioner`s Notice of Filing Deposition, Deposition of William Palmer filed.
PDF:
Date: 03/21/2007
Proceedings: Notice of Transfer.
PDF:
Date: 03/16/2007
Proceedings: Respondent`s Supplement to Witness and Exhibit Lists filed.
PDF:
Date: 03/09/2007
Proceedings: Petitioner`s Notice of Amendment to Witness List filed.
PDF:
Date: 03/07/2007
Proceedings: Petitioner`s Notice of Deposition and Application to Use at Trial filed.
PDF:
Date: 02/27/2007
Proceedings: Prehearing Stipulation filed.
PDF:
Date: 02/05/2007
Proceedings: Answer to Amended Administrative Complaint filed.
PDF:
Date: 02/01/2007
Proceedings: Order Granting Continuance and Re-scheduling Hearing (hearing set for March 28 and 29, 2007; 9:00 a.m.; Port Charlotte, FL).
PDF:
Date: 01/25/2007
Proceedings: Respondent`s Unopposed Motion for Continuance filed.
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Date: 01/25/2007
Proceedings: Order Granting Leave to Amend Administrative Complaint.
PDF:
Date: 01/23/2007
Proceedings: Petitioner`s Motion for Leave to File Amended Administrative Complaint filed.
PDF:
Date: 12/26/2006
Proceedings: Order Granting Continuance and Re-scheduling Hearing (hearing set for February 13 and 14, 2007; 9:00 a.m.; Port Charlotte, FL).
PDF:
Date: 12/20/2006
Proceedings: Unopposed Motion for Continuance filed.
PDF:
Date: 11/15/2006
Proceedings: Order of Pre-hearing Instructions.
PDF:
Date: 11/15/2006
Proceedings: Notice of Hearing (hearing set for January 9 and 10, 2007; 9:00 a.m.; Port Charlotte, FL).
PDF:
Date: 11/13/2006
Proceedings: Notice of Filing Production of Documents and Filing of Witness and Exhibit Lists.
PDF:
Date: 11/08/2006
Proceedings: Response to Initial Order filed.
PDF:
Date: 11/06/2006
Proceedings: Request for Production filed.
PDF:
Date: 11/06/2006
Proceedings: Notice of Service of Interrogatories filed.
PDF:
Date: 11/01/2006
Proceedings: Initial Order.
PDF:
Date: 10/31/2006
Proceedings: Administrative Complaint filed.
PDF:
Date: 10/31/2006
Proceedings: DOAH Rule 28-107.004 Request for Hearing filed.
PDF:
Date: 10/31/2006
Proceedings: Answer to Administrative Complaint filed.
PDF:
Date: 10/31/2006
Proceedings: Election of Proceeding filed.
PDF:
Date: 10/31/2006
Proceedings: Agency referral filed.

Case Information

Judge:
BRAM D. E. CANTER
Date Filed:
10/31/2006
Date Assignment:
03/19/2007
Last Docket Entry:
09/06/2007
Location:
Port Charlotte, Florida
District:
Middle
Agency:
ADOPTED IN PART OR MODIFIED
Suffix:
PL
 

Counsels

Related Florida Statute(s) (6):