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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.


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


Williams, Lovie of Houston
Order Number: 20175039
Date of Order:  4/24/2017
Action Taken:  Application granted for limited lines agent license but with probated four-year suspension
Violation:  Felony criminal offense


American Bankers Insurance Co. of Florida; American Security Insurance Company; Standard Guaranty Insurance Company; and Voyager Indemnity Insurance Company of Miami, FL
Order Number: 20174992
Date of Order:  3/14/2017
Action Taken:  Regulatory settlement agreement
Violation:  Regulatory settlement agreement as the result of ongoing multistate targeted market conduct examination of force-placed property insurance market


BHM Healthcare Solutions, Inc. of Houston
Order Number: 20174998
Date of Order:  4/21/2017
Action Taken:  Fined $8,450
Violation:  Failed to timely make independent review organization determination for life-threatening condition involving a health care services;


Distinguished Programs Insurance Brokerage, L.L.C. of New York, NY
Order Number: 20174976
Date of Order:  3/6/2017
Action Taken:  Fined $12,250
Violation:  Failed to timely file new or renewal surplus lines policies and related documents


Duenez, Diane of Pasadena
Order Number: 20175006
Date of Order:  3/28/2017
Action Taken:  (SOAH Docket No. 454-17-1828.C) General lines agent license with a property and casualty qualification revoked
Violation:  Felony criminal conviction


Eastland Title Company of Hillsboro
Order Number: 20175004
Date of Order:  3/28/2017
Action Taken:  Fined $2,800
Violation:  Failed to timely submit annual trust fund audit reports


Endeavor General Agency, L.L.C. of Royse City
Order Number: 20174999
Date of Order:  3/21/2017
Action Taken:  Fined $50,000
Violation:  Unilaterally expanded insureds' named driver coverage at renewal without request or consent when insureds had not accumulated 12 months of continuous coverage; Failed to properly renew those policies before accepting a premium or fee.


Envolve Pharmacy Solutions, Inc. of Fresno, CA
Order Number: 20174991
Date of Order:  3/14/2017
Action Taken:  Fined $45,000
Violation:  Used unapproved adverse determination letter templates as a utilization review agent


First Republic Title, L.L.C. of Houston
Order Number: 20174997
Date of Order:  3/21/2017
Action Taken:  Fined $15,000
Violation:  Improperly paid, allowed, or permitted a thing of value for engaging in business of title insurance or for soliciting or referring title insurance business.


First Title of Limestone County, Inc. of Groesbeck, Texas
Order Number: 20175016
Date of Order:  3/31/2017
Action Taken:  Fined $4,000
Violation:  Misrepresented completion of continuing education requirements by employees


Gonzales, Arturo of San Antonio
Order Number: 20174986
Date of Order:  3/10/2017
Action Taken:  (SOAH Docket No. 454-17-2399.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 insured, insurer or beneficiary


Gordwin, Joe Louis Jr. of Richmond
Order Number: 20174985
Date of Order:  3/10/2017
Action Taken:  Insurance adjuster all lines license granted and suspension is probated for remainder of period imposed by previous order
Violation:  Felony criminal conviction


Grasso, Joseph IV of Flower Mound, Texas
Order Number: 20174977
Date of Order:  3/6/2017
Action Taken:  Fined $5,250
Violation:  Operated a professional insurance adjuster firm without a license and delegated duties requiring a license


Martin, Quiante Camille of Tyler
Order Number: 20175005
Date of Order:  3/28/2017
Action Taken:  (SOAH Docket No. 454-17-2400.C) Application for a general lines agent license with a life, accident, and health qualification denied
Violation:  Felony criminal conviction


Nabors, Diana Kay of Mexia
Order Number: 20175019
Date of Order:  3/31/2017
Action Taken:  Fined $2,000
Violation:  Failed to comply with continuing education requirement


North American Title Company of Dallas
Order Number: 20175000
Date of Order:  3/27/2017
Action Taken:  (SOAH Docket No. 454-12-2825.C)Fined $15,000
Violation:  Failed to follow title insurance requirements for documenting escrow accounts; failed to timely pay premium for title insurance policies


Reed Bobby Lynn of Mexia
Order Number: 20175015
Date of Order:  3/31/2017
Action Taken:  Fined $1,000
Violation:  Failed to comply with continuing education requirement


Reed, Benjie Sims of Mexia
Order Number: 20175017
Date of Order:  3/31/2017
Action Taken:  Fined $2,500
Violation:  Failed to comply with continuing education requirement


Reed, Justin Elliott of Waco
Order Number: 20175018
Date of Order:  3/31/2017
Action Taken:  Fined $2,500
Violation:  Failed to comply with continuing education requirements


SHA, L.L.C. of Austin
Order Number: 20174983
Date of Order:  3/8/2017
Action Taken:  Fined $150,000
Violation:  Failed to provide network to ensure enrollees have adequate access to health care services


Williams, Lesley Karen of Round Rock
Order Number: 20175001
Date of Order:  3/27/2017
Action Taken:  (SOAH Docket No. 454-12-2825.C) Fined $3,000
Violation:  Failed to follow title insurance requirements for documenting escrow accounts


Ault, Jeffrey Steven of Austin
Order Number: 20174964
Date of Order:  2/28/2017
Action Taken:  Fined $2,500
Violation:  Engaged in business of insurance without a license


Boone, Nancy of Midland
Order Number: 20174937
Date of Order:  2/17/2017
Action Taken:  (SOAH Docket No. 454-17-1756.C) General lines agent license with a property and casualty qualification revoked
Violation:  Misappropriated, converted to own use, or illegally withheld money belonging to an insurer, HMO, insured, enrollee, or beneficiary; engaged in fraudulent or dishonest acts or practices


Boone, Shalonda of Midland
Order Number: 20174938
Date of Order:  2/17/2017
Action Taken:  (SOAH Docket No. 454-17-1757.C)General lines agent license with a property and casualty qualification revoked
Violation:  Misappropriated, converted to own use, or illegally withheld money belonging to an insurer, HMO, insured, enrollee, or beneficiary; engaged in fraudulent or dishonest acts or practices


Chavez, Rosa Marlen; Peace of Mind Insurance Agency of Beaumont
Order Number: 20144951
Date of Order:  2/22/2017
Action Taken:  Fined $5,250
Violation:  Misappropriated, converted to own use, or illegally withheld money belonging to an insurer, HMO, insured, enrollee, or beneficiary


Circosta, Andrew of Cedar Park
Order Number: 20174950
Date of Order:  2/22/2017
Action Taken:  Fined $1,000
Violation:  Engaged in business of insurance without a license


Cisneros, Laura Lynn of Laredo
Order Number: 20174958
Date of Order:  2/23/2017
Action Taken:  (SOAH Docket No. 454-17-1969.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 insurer


Cisneros, Ricky of Fort Worth
Order Number: 20174957
Date of Order:  2/23/2017
Action Taken:  (SOAH Docket No. 454-17-1829.C) Application for an adjuster trainee license denied
Violation:  Criminal history


Driscoll Children's Health Plan of Corpus Christi
Order Number: 20174965
Date of Order:  2/28/2017
Action Taken:  Fined $45,000
Violation:  Utilization review audit found use of unapproved adverse determination templates


Healthplan Services, Inc. of Tampa, FL
Order Number: 20174949
Date of Order:  2/22/2017
Action Taken:  Ordered to comply with insurance code and implement preventative measures
Violation:  Failed to maintain adequate books and records for limited number of transactions


Lane, James W. III of Whitesboro
Order Number: 20174946
Date of Order:  2/21/2017
Action Taken:  Fined $5,000; must cease and desist from performing acts of an insurance agent and engaging in business of insurance
Violation:  Performed the acts of an agent in Texas without holding a license; misappropriated, converted to own use, or illegally withheld money belonging to an insured


Molinet, Louis of New Braunfels
Order Number: 20174956
Date of Order:  2/22/2017
Action Taken:  (SOAH Docket No. 454-17-1830.C) General lines agent license with a life, accident, and health qualification revoked
Violation:  Misappropriated, converted to own use, or illegally withheld money belonging to an insurer, HMO, insured, enrollee or beneficiary


Orellana, Jose Rolando of Stafford
Order Number: 20174936
Date of Order:  2/15/2017
Action Taken:  (SOAH Docket No. 454-17-1643.C) Must pay restitution of $18,033; General lines agent license with a property and casualty qualification revoked
Violation:  Misappropriated, converted to his own use, or illegally withheld money belonging to an insured, insurer, or beneficiary


RiverSource Life Ins Co, RiverSource Life Ins Co of New York of Minneapolis, MN
Order Number: 20174948
Date of Order:  2/21/2017
Action Taken:  Regulatory settlement agreement
Violation:  Regulatory settlement agreement


Russek, Eric P.E. of League City
Order Number: 20174966
Date of Order:  2/28/2017
Action Taken:  Qualified inspector appointment placed on probation
Violation:  Failed to comply with requirements for windstorm inspections


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