Disciplinary & Industry Trends
The following are instances in which licensees or other persons violated the Florida Insurance Code and the administrative action the department has taken against them. Names have been altered and brevity used, but these real cases should discourage violations.
An investigation was opened on an owner of an insurance agency and its agent in charge (AIC) for misappropriating insurance premiums. They engaged in a scheme to divert escrow checks received from a title insurance agency into the bank account of their insurance agency. The funds were intended to pay the homeowner insurance premiums for several insureds. At no time did the two licensees ever secure homeowner’s insurance for the consumers. To conceal their actions, the agents issued invoices to the title agency reflecting false policy numbers. Once the investigation became known, the agents began issuing refunds and excuses to the consumers and the Department.
An investigation was opened on a life, health and variable annuity agent after the Centers for Medicare & Medicaid Services (CMS) suspended then revoked the agent’s application and access privileges, which were later terminated by the Federally Facilitated Marketplace (FFM) for enrolling consumers in the Marketplace without their knowledge and consent. Investigators acquired enrollment documentation from CMS which indicated the agent had enrolled consumers in multiple states in health insurance policies without their knowledge or consent.
Since July 2014, the Division of Investigative and Forensic Services has made hundreds of arrests of individuals who were licensed by the Department or required to be licensed but were operating without one. These arrests represent $4.47 million in fraud and involved insurance agents, bail bond agents, and public adjusters. [Florida CFO, Division of Investigative and Forensic Services, Insurance Fraud Press Releases]
Unauthorized Products & Entities
Customers responding to TV or radio ads, phone calls, mail, or email may not have the know-how or inclination to check whether a company is authorized to conduct business in Florida. You do. At the very least you have access to the Active Company Search provided by the OIR at www.FLOIR.com.
Make sure you have the complete and correct name of the insurance company — many names are very similar. Then:
To report possible unauthorized insurance, notify DFS at askDFS@MyFloridaCFO.com. The OFR oversees securities regulation — call 1-850-487-9687 or use their online search. View the list of unauthorized entities that have had action taken against them in Florida.
New & Important Terminology
Florida’s OIR provides the NAIC’s complete list of terminology for every state at www.FLOIR.com. AM Best also offers a glossary of insurance terms at www.ambest.com.
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