CFO Seal in Gold

Case Notes - May 2022

Case: A case was opened against a general lines agent alleging he submitted fraudulent wind mitigation and home inspection forms to insurers to qualify applicants for discounts on homeowners' insurance premiums.  A home inspector received a call to conduct an inspection on a property he had previously inspected.  Not recognizing the name or address, he requested a copy of the report.  Realizing the report was not his, but had his signature, he contacted the insurance agency owner and reported the issue. The agency owner conducted an internal audit of all policies written by the agent that provided the altered report.  Multiple altered wind mitigation and home inspection forms were discovered.   Copies of the altered reports were sent to the insurance companies that caused them to charge reduced premiums. The insurers reissued the policies with the correct premium, causing a premium increase.
Disposition: License suspended.

Case: An investigation was originally opened after the Department was notified this life, health and variable annuity agent had been terminated for cause. The insurer reported the subject collected premiums from hundreds of college students in the form of credit card payments and then failed to forward the premiums to the insurer. At the time of the subject's termination she owed nearly $300,000 in premiums to the insurer. Investigators obtained affidavits from the insurer and affected consumers.

After the subject's termination, she devised an elaborate scheme to fabricate a bogus insurance plan marketed to two major universities in South Florida. The unauthorized "insurer" routinely denied claims filed by the unsuspecting participants in the plan. After the unauthorized entity filed bankruptcy, the subject shut down the entity's website and disappeared, leaving the students and faculty with unpaid claims.
Disposition: License revoked.

Case: This case was opened on a health agent based on a insurer's termination for cause that alleged the agent committed fraud and forgery by submitting several insurance policy applications without the knowledge or authorization of the consumers.
Disposition: License revoked.

Case: An investigation was opened on a life, health and variable annuity agent based on information provided by the 
Financial Industry Regulatory Authority (FINRA). FINRA suspended and fined the agent for changing the beneficiaries on two variable life insurance policies insuring the life of a senior customer to the agent's own spouse and adult children.  The insured provided a statement to investigators that the signatures on the beneficiary change forms were not his. The named beneficiaries had no insurable interest in the life of the policy holder. The policies totaled $350,000 in death benefits. The unlawful beneficiary designations were reversed.
Disposition: License suspended. 




 

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