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DISCIPLINARY ORDERS POSTED for 2017

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.


Akinfenwa, Abiodun Kayode of Euless
Order Number: 20175146
Date of Order:  7/17/2017
Action Taken:  Fined $2,600
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insurer


Eskue, Nancy Ruth of Lewisville
Order Number: 20175163
Date of Order:  7/28/2017
Action Taken:  Application granted for personal lines property and casualty license with probated four-year suspension
Violation:  Felony criminal conviction


Goldberg, Michael Niel of Austin
Order Number: 20175164
Date of Order:  7/31/2017
Action Taken:  Fined $5,500; general lines agency license granted to Mike Goldberg and Associates, Inc., dba Goldberg and Associates
Violation:  Allowed employees to engage in business of insurance without proper licenses


Maese, Alicia Zamora of San Elizario
Order Number: 20175165
Date of Order:  7/31/2017
Action Taken:  (SOAH Docket No. 454-17-3948.C) Funeral prearrangement life license revoked
Violation:  Failed to timely pay restitution


National Unity Insurance Company of San Antonio
Order Number: 20175147
Date of Order:  7/17/2017
Action Taken:  (SOAH Docket No. 454-17-4056.C) Fined $30,000
Violation:  Failed to properly renew named driver policies; accepted premium or fees without receiving disclosures; failed to include disclosures in forms; used unapproved form


Old Republic Insurance Company of Greensburg, PA
Order Number: 20175148
Date of Order:  7/17/2017
Action Taken:  Regulatory settlement agreement in ongoing multistate targeted market conduct examination of travel insurance business
Violation:  Regulatory settlement agreement in ongoing multistate targeted market conduct examination of travel insurance business


Soto, Jacqueline of Howe
Order Number: 21075166
Date of Order:  7/31/2017
Action Taken:  (SOAH Docket No. 454-17-4389.C) General lines agent license with property and casualty qualification revoked
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


All Savers Insurance Company of Indianapolis, IN
Order Number: 21075114
Date of Order:  6/16/2017
Action Taken:  Must have prior approval of adequacy of networks from department and provide updated credentialing dates for providers before reentering the PPO and EPO market
Violation:  Failed to submit waiver request and access plan to address inadequate networks; failed to meet credentialing standards


Brooks, Christina of Dallas
Order Number: 20175118
Date of Order:  6/22/2017
Action Taken:  Application for adjuster all lines license granted with four-year suspension probated
Violation:  Felony criminal conviction


Brown, LaTonya Marie of Dallas
Order Number: 20175119
Date of Order:  6/22/2017
Action Taken:  Application granted for general lines agent license with life, accident, and health qualification with four-year suspension probated
Violation:  Felony criminal conviction


Castillo, Lila Lizette of Mansfield
Order Number: 20175138
Date of Order:  6/30/2017
Action Taken:  (SOAH Docket No. 454-17-4102.C) General lines agent license with a property and casualty qualification revoked
Violation:  Engaged in fraudulent or dishonest acts or practices; misrepresented, converted to own use, or illegally withheld money belonging to an insurer


Christus Health Plan of Irving
Order Number: 20175121
Date of Order:  6/23/2017
Action Taken:  Fined $85,000
Violation:  Violations found in triennial examination of HMO


Cooney, Brandon M. of Tampa, FL
Order Number: 20175101
Date of Order:  6/7/2017
Action Taken:  (SOAH Docket No. 454-17-3947.C) Non-resident general lines agent license with property and casualty, and life, accident, and health qualifications revoked
Violation:  Felony criminal conviction


Jackson, Andrea Nichelle of Tyler
Order Number: 20175120
Date of Order:  6/22/2017
Action Taken:  (SOAH Docket No. 454-17-3949.C) County mutual agent license and general lines agent license with a life, accident, and health qualification revoked
Violation:  Misappropriated, converted to her own use, or illegally withheld money belonging to an insurer


McRae, Yolanda Ann of Desoto
Order Number: 20175112
Date of Order:  6/15/2017
Action Taken:  (SOAH Docket No. 454-17-3051.C) General lines agent 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, HMO, insured, enrollee or beneficiary


Nixon, Trellis Trevon of Plano
Order Number: 20175110
Date of Order:  6/15/2017
Action Taken:  (SOAH Docket No. 454-17-3139.C) Application for a life agent license is denied
Violation:  Felony criminal conviction


Piniones, Dennis Cardenio of Houston
Order Number: 20175117
Date of Order:  6/22/2017
Action Taken:  Fined $3,000
Violation:  Misrepresented, converted to his own use, or illegally withheld money belonging to an insurer


Reyes, Stephanie Lynn of Dallas
Order Number: 20175102
Date of Order:  6/7/2017
Action Taken:  (SOAH Docket No. 454-17-3800.C) Escrow officer license revoked; must pay restitution
Violation:  Misappropriated, converted to own use, or illegally withheld money; engaged in fraudulent or dishonest acts or practices


Riveros, Cristian Marcelo of Haslet
Order Number: 20175116
Date of Order:  6/22/2017
Action Taken:  Fined $1,000
Violation:  Allowed staff member to engage in business of insurance without proper license


Rodriguez, Jennifer Rene of New Braunfels
Order Number: 20175111
Date of Order:  6/15/2017
Action Taken:  (SOAH Docket No. 454-17-3005.C) Application for a general lines agent license with a life, accident, and health qualification denied
Violation:  Felony criminal conviction


Smith, Renee Chante of Katy
Order Number: 20175137
Date of Order:  6/30/2017
Action Taken:  (SOAH Docket No. 454-17-4047.C) General lines agent license with a life, accident, and health qualification revoked
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


Universal Insurance Company of North America of Sarasota, FL
Order Number: 20175099
Date of Order:  6/1/2017
Action Taken:  Fined $10,000
Violation:  Allowed persons to adjust claims without holding required license; failed to timely respond to TDI inquiry


Villegas, Blair Nichole Mossman of Quinlan
Order Number: 20175103
Date of Order:  6/7/2017
Action Taken:  (SOAH Docket No. 454-17-3186.C) General lines agent license with a life, accident, and health qualification, county mutual agent license, and personal lines property and casualty agent license revoked; must pay restitution
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use or illegally withheld money belonging to an insured, insurer, or beneficiary


Aetna Life Insurance Company of Hartford, CT
Order Number: 20175069
Date of Order:  5/9/2017
Action Taken:  Fined $100,000
Violation:  Failed to timely pay clean claims


American Bankers Insurance Co. of Florida of Miami, FL
Order Number: 20175066
Date of Order:  5/5/2017
Action Taken:  Fined $35,000
Violation:  Failed to file rates and forms for identity theft insurance


Falcon Insurance Co, Talon Financial Services, LLC of Oak Brook, IL
Order Number: 20175068
Date of Order:  5/9/2017
Action Taken:  Fined $80,000
Violation:  Violations of Texas Insurance Code and Texas Administrative Code found during market conduct examination


Farmers Texas County Mutual Ins. Co. of Austin
Order Number: 20175087
Date of Order:  5/22/2017
Action Taken:  Fined $15,000
Violation:  Omitted rules in rate filing associated with recouping fee from policyholders


Francis, Jarel of Houston
Order Number: 20175061
Date of Order:  5/3/2017
Action Taken:  (SOAH Docket No. 454-17-3066.C) General lines agent license with life, accident, and health, and property and casualty qualifications revoked
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


Hatfield, Clayton Alan of San Mateo, CA
Order Number: 20175082
Date of Order:  5/17/2017
Action Taken:  Fined $10,000; must pay restitution; suspension of non-resident general lines agent license with property and casualty, and life, accident and health qualifications probated for one year
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


Kirby, Jim B. Jr. of Powderly
Order Number: 20175071
Date of Order:  5/9/2017
Action Taken:  (SOAH Docket No. 454-17-3033.C) General lines agent license with a life, accident, and health qualification revoked; must pay restitution
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


McGriff, Seibels & Williams of Texas, Inc. of Houston
Order Number: 20175062
Date of Order:  5/3/2017
Action Taken:  Fined $4,000
Violation:  Failed to timely file new or renewal surplus lines policies and related documents


Memorial Herman Health Plan, Inc. of Houston
Order Number: 20175067
Date of Order:  5/9/2017
Action Taken:  Fined $20,000
Violation:  Failed to timely pay clean claims; failed to accurately report quarterly claims payment information


Ridge, Jack Ransom, Jr. of Austin
Order Number: 20175073
Date of Order:  5/11/2017
Action Taken:  Application granted for general lines agent license with a life, accident, and health qualification with probated four-year suspension
Violation:  Criminal background


Risinger, Garry Nathan of Wills Point, TX
Order Number: 20175072
Date of Order:  5/9/2017
Action Taken:  (SOAH Docket No. 454-17-3187.C) General lines agent license with life, accident, and health and property and casualty qualifications revoked
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


Sendero Health Plans, Inc. of Austin
Order Number: 20175070
Date of Order:  5/9/2017
Action Taken:  Fined $15,000
Violation:  Failed to meet credentialing standards


Broadspire Services, Inc. of Atlanta, GA
Order Number: 20175043
Date of Order:  4/24/2017
Action Taken:  Fined $40,000
Violation:  Used unapproved adverse determination letter templates as a utilization review agent


Celtic Insurance Company of Chicago, IL
Order Number: 20175042
Date of Order:  4/24/2017
Action Taken:  Fined $30,000
Violation:  Failed to meet credentialing standards for health care practitioners; failed to appropriately monitor delegated entities that perform provider credentialing


Cigna Healthcare of Texas, Inc. of Plano
Order Number: 20175028
Date of Order:  4/6/2017
Action Taken:  Fined $40,000
Violation:  Failed to meet credentialing standards for health care practitioners; failed to appropriately monitor delegated entities that perform provider credentialing


Conrad, Parker Rouse of San Francisco, CA
Order Number: 20175044
Date of Order:  4/24/2017
Action Taken:  Fined $35,000
Violation:  Served as principal shareholder for company that performed acts of an agency without first obtaining agency license


Dairyland County Mutual Insurance Companny of Texas of Stevens Point, WI
Order Number: 20175047
Date of Order:  4/25/2017
Action Taken:  Fined $150,000
Violation:  Replaced personal automobile policies written for a term of less than one year without the insureds' request, prior to the 12 month anniversary of the policy; accepted premiums or fees without making the required disclosures to applicants and insureds for new and renewal named driver personal automobile insurance policies.


Federated Mutual Insurance Company of Owatonna, MN
Order Number: 20175029
Date of Order:  4/6/2017
Action Taken:  Fined $30,000
Violation:  Failed to meet credentialing standards


First Nationwide Title Agency of Texas, L.L.C. of Austin
Order Number: 20175041
Date of Order:  4/24/2017
Action Taken:  Fined $4,000
Violation:  Failed to timely submit annual trust fund account audit reports


Harris, Vernon Keith of Baltimore, MD
Order Number: 20175035
Date of Order:  4/24/2017
Action Taken:  Application granted for adjuster all lines license designated for home state Texas but with probated five-year suspension
Violation:  Felony criminal conviction


Infinity County Mutual Insurance Company of Birmingham, AL
Order Number: 20175048
Date of Order:  4/25/2017
Action Taken:  Fined $200,000
Violation:  Overcharged premiums due to the use of an incorrect rating factor; failed to mail requisite oral disclosures; failed to receive signed copies of requisite written disclosures; failed to confirm contemporaneously in writing the provision of the oral disclosure. Also, failed to timely acknowledge receipt of a claim; failed to timely notify insureds in writing of a settlement


Insurance 3 Group, Inc. of Dallas
Order Number: 20175034
Date of Order:  4/24/2017
Action Taken:  Fined $3,000
Violation:  Misappropriated, converted to own use or illegally withheld money belonging to an insured


Lucia, David Christian of Brdge City
Order Number: 20175030
Date of Order:  4/6/2017
Action Taken:  Must pay restitution of $2,085
Violation:  Withheld money belonging to an insurer; engaged in fraudulent or dishonest acts or practices


Maurer, Mathew Smith of Midland
Order Number: 20175053
Date of Order:  4/28/2017
Action Taken:  (SOAH Docket No. 454-17-0101.C) Application for a funeral prearrangement life license denied
Violation:  Criminal history; engaged in fraudulent or dishonest acts or practices


Russell, Inga Patrice of Dallas
Order Number: 20175037
Date of Order:  4/24/2017
Action Taken:  Application granted for personal lines agent license with a property and casualty qualification but with probated two-year suspension
Violation:  Felony criminal offense


Sample, Derek Jarrod of Katy
Order Number: 20175038
Date of Order:  4/24/2017
Action Taken:  (SOAH Docket No. 454-15-2884.C) Fined $8,000; must complete additional six hours of continuing education in ethics
Violation:  Engaged in fraudulent or dishonest acts or practices; misappropriated, converted to own use, or illegally withheld money belonging to an insurer


Superior HealthPlan, Inc. of Austin
Order Number: 20175040
Date of Order:  4/24/2017
Action Taken:  Fined $30,000
Violation:  Failed to have monitoring plan for delegated entity


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