Texas’ Jan. Enforcements Result in Nearly $570K in Fines, Restitution

March 4, 2008

Enforcement actions taken by The Texas Department of Insurance that became final during January 2008 include nine license revocations, a license denial and fines and restitution totaling $569,867.

Only final orders are listed. An 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’s orders are subject to appeal to state district court.

TDI final disciplinary orders for January 2008:

Allstate Texas Lloyds of Irving
Order Number: 080011
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $10,000 fine; Must file reports on status of all complaints
Violation: Allegedly failed to timely acknowledge and respond to claims following Hurricane Rita

Blanscet, Matthew Julius of Houston
Order Number: 080017
Date of Order: 1/10/2008
Order Final In: January
Action Taken: Texas Escrow Officer’s License revoked
Violation: Made false statements on license applications

Brown, Jack Arnold of Tyler
Order Number: 080065
Date of Order: 1/29/2008
Order Final In: January
Action Taken: General Life, Accident and Health License revoked
Violation: Felony conviction involving moral turpitude; Engaged in fraudulent or dishonest acts or practices

Care Improvement Plus of Texas Insurance Company of San Antonio
Order Number: 080005
Date of Order: 1/4/2008
Order Final In: January
Action Taken: $25,000 fine
Violation: Failed to provide notice of plans to maintain its principal offices outside the state; Failed to timely file required financial statements

Carson, Christina Dawn Marie of Dallas
Order Number: 080059
Date of Order: 1/28/2008
Order Final In: January
Action Taken: $1,500 fine; Must complete 30 hours of continuing education
Violation: Failed to comply with continuing education requirements

Community First Health Plans Inc.; Medimpact Healthcare Systems Inc. of San Antonio; San Diego, Calif.
Order Number: 080056
Date of Order: 1/28/2008
Order Final In: January
Action Taken: $200,000 fine
Violation: Failed to pay clean claims in a timely manner

Davidson, Stephen D., UBA Insurance Services Inc. of Fort Worth
Order Number: 080014
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $10,000 fine
Violation: Required persons applying for individual insurance policies from Unicare to apply for and maintain a membership in an associaton

DF Institute Inc. DBA Kaplan Financial of Indianapolis, Ind.
Order Number: 080044
Date of Order: 1/17/2008
Order Final In: January
Action Taken: $8,400 fine
Violation: Taught continuing education courses without valid course certifications

Escalera, Carlos Javier of Grand Prairie
Order Number: 080057
Date of Order: 1/28/2008
Order Final In: January
Action Taken: Limited Lines License approved with two year probationary period
Violation: State Jail Felony

First Strategic Title Incorporated of Wichita Falls
Order Number: 080012
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $7,000 fine
Violation: Failed to timely provide an annual trust fund account audit report

Folsom, Mary Camille of Mauriceville
Order Number: 080031
Date of Order: 1/14/2008
Order Final In: January
Action Taken: $966 Restitution; General Life, Accident and Health License and General Property and Casualty License revoked
Violation: Engaged in fraudulent or dishonest acts or practices; Misappropriated or converted money belonging to an insurer or insured

Green, Barbara Rounsavell of Grand Prairie
Order Number: 080016
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $1,500 fine; Must complete 15 hours of continuing education; One year suspension of Insurance Adjuster License
Violation: Failed to comply with continuing education requirements

Hernandez, Margarito Borrego of San Antonio
Order Number: 080019
Date of Order: 1/10/2008
Order Final In: January
Action Taken: Limited Lines License and General Life, Accident and Health License revoked
Violation: Failed to comply with Commissioner’s Order regarding continuing education

Home Life Financial Assurance Corporation of Piscataway, N.J.
Order Number: 080020
Date of Order: 1/10/2008
Order Final In: January
Action Taken: Utilization Review Agent certificate of authority revoked
Violation: Failed to comply with Commissioner’s Order

IRO America of Austin
Order Number: 080045
Date of Order: 1/17/2008
Order Final In: January
Action Taken: Certificate of Registration previously held by IRO America surrendered and canceled
Violation: Allegedly failed to maintain confidentiality of records

Matagorda County Title Company of Bay City
Order Number: 080058
Date of Order: 1/28/2008
Order Final In: January
Action Taken: $4,900 fine
Violation: Failed to timely provide an annual trust fund account audit report

Mercy Health Plans of Missouri Inc of Chesterfield, Mo.
Order Number: 080006
Date of Order: 1/4/2008
Order Final In: January
Action Taken: $100,000 fine
Violation: Failed to pay clean claims in a timely manner

Moody-Cooper, Linda Sue of Katy
Order Number: 080018
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $5,000 fine; Escrow Officer’s License revoked
Violation: Made a material misrepresentation on a license application; Obtained a license by fraud or misrepresentation; Made false statements on license applications

Perez, Jody Mike of Lubbock
Order Number: 080015
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $3,000 fine; $1,434 restituton; General Life, Accident and Health License suspended for one year
Violation: Engaged in fraudulent or dishonest acts or practices; Misappropriated or converted money belonging to an insurer or insured

Pinckard, Rebecca Sealy of Houston
Order Number: 080008
Date of Order: 1/4/2008
Order Final In: January
Action Taken: Texas Escrow Officer’s License revoked
Violation: Made false statements on license applications

Poage, John Moyer of Deephaven, Minn.
Order Number: 080061
Date of Order: 1/28/2008
Order Final In: January
Action Taken: Insurance Adjuster License application denied
Violation: Engaged in fraudulent or dishonest acts or practices; Criminal conduct

Premium Title Company Inc.; Kennedy, Robert Lee; Kennedy, Crystal Lea of Plano and McKinney
Order Number: 080007
Date of Order: 1/4/2008
Order Final In: January
Action Taken: $23,000 in fines; Texas Escrow Officer’s Licenses held by Robert Lee Kennedy and Crystal Lea Kennedy revoked
Violation: Unauthorized title insurance

Smith, Lorenza III of Cedar Hill
Order Number: 080060
Date of Order: 1/28/2008
Order Final In: January
Action Taken: $1,500 fine; Must complete 30 hours of continuing education; General Life, Accident and Health License suspended for one year
Violation: Failed to comply with continuing education requirements

Springfield, Charles Rex of Orange
Order Number: 080062
Date of Order: 1/28/2008
Order Final In: January
Action Taken: Restitution; General Property and Casualty License and General Life, Accident and Health License revoked
Violation: Engaged in fraudulent or dishonest acts or practices; Misappropriated or converted money belonging to an insurer or insured

United Healthcare Insurance Company of Hartford, Conn.
Order Number: 080013
Date of Order: 1/10/2008
Order Final In: January
Action Taken: $166,667 fine
Violation: Failed to renew small employer group health benefit plans; Failed to market small employer health benefit plans as required

Source: Texas Department of Insurance, www.tdi.state.tx.us

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