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DISCIPLINARY ORDERS POSTED for 2015

TEXAS DEPARTMENT OF INSURANCE

The Texas Department of Insurance has issued the following disciplinary orders. Only final orders are listed. A Commissioner of Insurance order imposing disciplinary measures becomes final 20 days after the agent or insurance company has received notice of the order unless a motion for rehearing is filed within that period. A motion for rehearing stays the finality of an order until the Commissioner of Insurance acts upon the motion or upon the operation of law. Commissioner of Insurance orders are subject to appeal to state district court.

A Commissioner of Workers’ Compensation consent order (settlement) imposing sanctions becomes final upon signature of the Commissioner of Workers’ Compensation. System participants are entitled to a hearing at the State Office of Administrative Hearings (SOAH) if they do not wish to settle the enforcement matter. If there is a hearing on an enforcement matter at SOAH, the SOAH Administrative Law Judge will issue a Proposal for Decision (PFD). The Commissioner of Workers’ Compensation will then consider the case, and shall issue a decision or order that may become final. The decision or order that may become final will become final in accordance with Government Code chapter 2001, subchapters F and G.

Copies of Commissioner of Insurance and or Commissioner of Workers' Compensation orders may be obtained only by an open records request. Your request can be sent by email, fax, mail, or in person. Learn more about how to request information.


AmeriGroup Texas, Inc. of Houston
Order Number: 4217
Date of Order:  12/10/2015
Action Taken:  Fined $40,000
Violation:  Failed to correct violations found in quality of care examination


Cypress Texas Lloyds of Jacksonville, FL
Order Number: 4174
Date of Order:  11/4/2015
Action Taken:  Must pay restitution to qualifying policyholders
Violation:  Used an unfiled rate


Hobbs, Phillip Jermaine of Cedar Hill
Order Number: 4175
Date of Order:  11/4/2015
Action Taken:  (SOAH Docket No. 454-15-5403.C) Fined $4,366; general lines life, accident, and health license revoked
Violation:  Misappropriated, converted to personal use or illegally withheld money belonging to insurer, insured, or enrollee


Katzenellenbogen, Mark Frank of Houston
Order Number: 4183
Date of Order:  11/16/2015
Action Taken:  (SOAH Docket No. 454-15-0188.C) Surplus lines license and general lines property and casualty license revoked
Violation:  Failed to comply with license requirements of Surplus Lines Stamping Office of Texas


PacfiCare Life and Health Insurance Company of Cypress, CA
Order Number: 4176
Date of Order:  11/5/2015
Action Taken:  Fined $10,000
Violation:  Failed to file or timely file network adequacy reports; failed to report number of clean claims received


American Matar International, Inc. of Pasadena, CA
Order Number: 4150
Date of Order:  10/12/2015
Action Taken:  Fined $8,000
Violation:  Unauthorized insurance


Jones, Malindiene E. of Houston
Order Number: 4138
Date of Order:  10/6/2015
Action Taken:  (SOAH Docket No. 454-15-5059.C) Must pay restitution of $848; general lines life, accident, and health license revoked
Violation:  Misappropriated, converted to personal use and illegally withheld money belonging to an insurer


Cordero, Zenaida of La Feria
Order Number: 4103
Date of Order:  9/8/2015
Action Taken:  (SOAH Docket No. 454-15-4052.C)General lines life, accident, health and HMO license revoked; must pay restitution of $2,332
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insurer, insured or beneficiary


Goodwin, Princess of Glenn Heights
Order Number: 4102
Date of Order:  9/8/2015
Action Taken:  General lines property and casualty license application granted with two years probated suspension
Violation:  Criminal history includes felony criminal conviction


Leos, Jesus Javier of El Paso
Order Number: 4125
Date of Order:  9/23/2015
Action Taken:  (SOAH Docket No. 454-15-4589.C)General lines life, accident, and health license revoked; must pay restitution of $17,931
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insurer, insured or beneficiary


American Risk Insurance Company, Inc. of Houston
Order Number: 4093
Date of Order:  8/21/2015
Action Taken:  Fined $60,000
Violation:  Failed to include mandatory contractual provisions in managing general agent (MGA) contracts; failed to conduct semiannual examinations of MGAs; failed to adopt and implement reasonable standards for the prompt investigation of claims; failed to attempt in good faith to effect a prompt, fair, and equitable settlement; withheld investigation of a claim; failed to accept or reject claims within 15 business days after insurer received all items required to secure final proof of loss; failed to timely pay claims


Lawrence, Angela Victoria of San Antonio
Order Number: 4081
Date of Order:  8/12/2015
Action Taken:  (SOAH Docket No. 454-15-4730.C)Escrow officer license revoked
Violation:  Failed to provide complete information on closing and settlement statements; Misappropriated, converted to own use or illegally withheld money belonging to a title insurance agent, direct operation, or another person


LenderLive Title Agency, LLC of Dallas
Order Number: 4094
Date of Order:  8/21/2015
Action Taken:  Fined $1,000
Violation:  Failed to timely submit annual trust fund account audit


SafeHealth Life Insurance Company of Irvine, CA
Order Number: 4078
Date of Order:  8/12/2015
Action Taken:  Fined $25,000
Violation:  Failed to timely file complete network adequacy reports; failed to timely file quarterly prompt payment reports for vision claims


Chappel, Jovani L. of Dayton, OH
Order Number: 4054
Date of Order:  7/20/2015
Action Taken:  (SOAH Docket No. 454-15-2130.C) General lines life, accident, and health insurance license revoked
Violation:  Incarceration for a felony criminal conviction


Independent Review, Inc. of Deerfield Beach, FL
Order Number: 4053
Date of Order:  7/20/2015
Action Taken:  (SOAH Docket No.454-15-4150.C) Independent review organization license revoked
Violation:  Failed to timely make determinations for a health condition; Failed to adequately staff telephone services


Kennedy, Rae'Lene of McKinney
Order Number: 4039
Date of Order:  7/2/2015
Action Taken:  (SOAH Docket No. 454-15-3991.C) Escrow officer license revoked
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insurer, insured or beneficiary


Morris, Edward M. of Killeen
Order Number: 4061
Date of Order:  7/27/2015
Action Taken:  (SOAH Docket No. 454-15-4415.C)Limited lines license revoked
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insurer, insured or beneficiary


Williams, Keith of Houston
Order Number: 4070
Date of Order:  7/30/2015
Action Taken:  (SOAH Docket No. 454-15-4051.C) Fined $1,400 fine; must pay restitution of $4,340; county mutual license and general lines license with life, accident, and health and property and casualty qualifications revoked
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insurer, insured or beneficiary; failed to comply with continuing education requirements;


American Modern Home Ins Co, American Modern Select Ins Co, American Family Home Ins Co, American Southern Home Ins Co, American Western Home Ins Co of Cincinnati, OH
Order Number: 3989
Date of Order:  6/1/2015
Action Taken:  Regulatory settlement agreement resulting from multi-state targeted market conduct examination
Violation:  Fined total of $6 million with $864,847 allotted to TDI


Gage, Kenrick Demione of McAllen
Order Number: 3990
Date of Order:  6/1/2015
Action Taken:  Fined $500
Violation:  Failed to obtain public insurance adjuster license for his agency prior to performing duties of public insurance adjuster


Metropolitan Escrow and Title, L.L.C. of Houston
Order Number: 4019
Date of Order:  6/25/2015
Action Taken:  Fined $1,400
Violation:  Failed to timely submit annual trust fund account audit


Metropolitan Life Insurance Company of Tampa, FL
Order Number: 4014
Date of Order:  6/11/2015
Action Taken:  Fined $20,000
Violation:  Failed to timely file annual network adequacy report; failed to timely file quarterly prompt payment reports for vision claims for two years


Safeco General Agency, Inc. of Seattle, WA
Order Number: 3991
Date of Order:  6/1/2015
Action Taken:  Fined $25,000
Violation:  Failed to properly appoint agents; failed to provide signed rejections for uninsured motorist or personal injury protection coverage


Sterling Life Insurance Company of Atlanta, GA
Order Number: 4016
Date of Order:  6/16/2015
Action Taken:  Fined $30,000
Violation:  Failed to timely tile annual network adequacy reports; failed to timely pay clean claims


Tiago Title, L.L.C. of Dallas
Order Number: 4002
Date of Order:  6/4/2015
Action Taken:  Fined $1,200
Violation:  Failed to timely submit annual trust fund account audit


Ector County Abstract & Title Co., Inc. of Odessa
Order Number: 3953
Date of Order:  5/11/2015
Action Taken:  Fined $3,000
Violation:  Misrepresented completion of continuing education requirements by escrow officer


Fleuridor, Brian of Boca Raton, FL
Order Number: 3958
Date of Order:  5/12/2015
Action Taken:  (SOAH Docket No. 454-15-2769.C) General lines life, accident, and health license revoked
Violation:  Felony criminal conviction


Ogilvy, Michael Alex of Odessa
Order Number: 3954
Date of Order:  5/11/2015
Action Taken:  Fined $3,000
Violation:  Failed to comply with continuing education requirements


Rosado, Marcos of Austin
Order Number: 3943
Date of Order:  5/1/2015
Action Taken:  Fined $750
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insurer, insured or beneficiary


Stewart Title Company of Houston
Order Number: 3967
Date of Order:  5/15/2015
Action Taken:  Fined $50,000
Violation:  Failed to accurately disclose payments on settlement statements; failed to comply with title procedural and rate rules


Contact Escrow, Inc. of Camarillo, CA
Order Number: 3864
Date of Order:  3/16/2015
Action Taken:  Cease and desist
Violation:  Engaged in unauthorized business of insurance


Evergreen Indemnity L.T.D.; Lucas Baxter Hartford; Hartford, Inc. DBA Evergreen MGA of Barbados, W.I. and Lewiston, ME
Order Number: 3858
Date of Order:  3/12/2015
Action Taken:  Cease and desist from doing acts which constitute business of insurance, except to fulfill remaining contractual obligations; Hartford, Inc. DBA Evergreen MGA fined $5,000; General lines property and casualty license held by Lucas Hartford surrendered and cancelled;
Violation:  Unauthorized insurance


Gaona, Antonio of Houston
Order Number: 3860
Date of Order:  3/12/2015
Action Taken:  General lines property and casualty license and property and casualty adjuster license revoked
Violation:  Engaged in fraudulent or dishonest acts or practices


Pickens, Debora Parks of Austin
Order Number: 3863
Date of Order:  3/16/2015
Action Taken:  Cease and desist
Violation:  Engaged in unauthorized business of insurance


Poisson, Nichole Lurraine of Sturgis, SD
Order Number: 3849
Date of Order:  3/5/2015
Action Taken:  Fined $500; Must cease and desist from doing acts which constitute business of insurance, except as authorized
Violation:  Unauthorized insurance


State Farm Lloyds of Dallas
Order Number: 3854
Date of Order:  3/10/2015
Action Taken:  Must pay refunds and interest as ordered by commissioner of insurance
Violation:  Rate refund settlement


The Travelers Indemnity Co of Connecticut; The Travelers Indemnity Co.; Farmington Casualty Co.; The Charter Oak Fire Ins Co.; The Standard Fire Ins Co.; The Travelers Indemnity Co of America; Travelers Casualty and Surety Co; Travelers Property Casualty Co. of America; United States Fidelity and Guaranty Co. and Fidelity and Guaranty Insurance Co. of Hartford, CT and Saint Paul, MN
Order Number: 3855
Date of Order:  3/10/2015
Action Taken:  Fined $1.2 million; Must pay restitution to qualifying policyholders to be reported by July 1, 2015
Violation:  Delivered and issued unapproved workers’ compensation endorsement forms; Used unfiled and unapproved terrorism rates; incorrectly calculated terrorism premium, total estimated policy cost, and estimated annual premium for negotiated deductible and retrospectively rated policies


Tolli, Bryan J. of Scarborough, ME
Order Number: 3859
Date of Order:  3/12/2015
Action Taken:  Fined $10,000; Surplus lines license granted; Cease and desist from doing acts which constitute business of insurance, except as authorized
Violation:  Unauthorized insurance


Toney-Strickland, Tilana of Pflugerville
Order Number: 3871
Date of Order:  3/23/2015
Action Taken:  Cease and desist
Violation:  Engaged in unauthorized business of insurance


Corepointe Insurance Company of Birmingham, MI
Order Number: 3807
Date of Order:  2/5/2015
Action Taken:  Fined $10,000
Violation:  Deficiencies found in evaluation of loss control information and services


Hernandez, Victoria E. of Dallas
Order Number: 3842
Date of Order:  2/27/2015
Action Taken:  (SOAH Docket No. 454-14-1641.C) Fined $1,000
Violation:  Failed to file assumed name for insurance agency business


JMB Insurance Agency, Inc. of Chicago, IL
Order Number: 3843
Date of Order:  2/27/2015
Action Taken:  Fined $1,400
Violation:  Failed to timely file new or renewal surplus lines policies and related documents; Failed to pay assessed fees


Ramos, Veronica R. of Austin
Order Number: 3813
Date of Order:  2/11/2015
Action Taken:  Fined $1,000
Violation:  Allowed employee who did not hold a proper license to sell an auto insurance policy


Trustmark Life Insurance Company of Lake Forest, IL
Order Number: 3808
Date of Order:  2/5/2015
Action Taken:  Fined $30,000
Violation:  Failed to comply with requirements for utilization review agents


Allianz Life Insurance Company of North America; Allianz Life Insurance Company of New York of Minneapolis, MN
Order Number: 3795
Date of Order:  1/28/2015
Action Taken:  Regulatory settlement agreement including fine of $4.738 million to be allocated to participating state insurance departments
Violation:  Multistate targeted market conduct examination of claims practices including efforts to identify owners and beneficiaries of unclaimed proceeds


American Specialty Health Group, Inc.; Aetna Health, Inc.; Aetna Life Insurance Co.; Cigna Healthcare of Texas, Inc.; Connecticut General Life Insurance Co.; Cigna Health and Life Insurance Co. of San Diego, CA; Blue Bell, PA; Harford, CT; Plano; Bloomberg, CT
Order Number: 3778
Date of Order:  1/15/2015
Action Taken:  Fined $60,000
Violation:  Delegated and performed utilization review without a utilization review agent certificate


Arellano, Hector Jr. of Houston
Order Number: 3775
Date of Order:  1/12/2015
Action Taken:  (SOAH Docket No. 454-14-4407.C) General lines property and casualty insurance license revoked
Violation:  Engaged in fraudulent and dishonest acts or practices


Fleming, Ronald Gene of Lubbock
Order Number: 3797
Date of Order:  1/29/2015
Action Taken:  (SOAH Docket No. 454-15-1557.C) Viatical, life settlement broker license revoked; General lines life, accident, and health license revoked; Application for a general lines life, accident, and health license denied; must pay restitution of $201,780.
Violation:  Engaged in fraudulent and dishonest acts or practices


Hall, Patrick J. of Houston
Order Number: 3758
Date of Order:  1/5/2015
Action Taken:  General lines life, accident, and health license granted; license suspended for two years, probated pending compliance with terms and conditions of order
Violation:  Criminal history


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