Texas Orders $4.4M in Fines and Restitution in June

August 8, 2008

Enforcement actions by Texas Commissioner Mike Geeslin in June included five license revocations, a license denial, and fines and restitution totaling $4,422,505, theTexas Department of Insurance reported.

Copies of Geeslin’s orders may be obtained by contacting TDI’s Public Information Office. 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.

June 2008 enforcement actions:

Aguirre, Isabel Fernandez of El Paso
Order Number: 080552
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $2,000 fine; $1,000 restitution; Must complete 15 hours of continuing education; Must remove the state seal from all marketing materials
Violation: Materially misrepresented terms and conditions of an insurance policy; Distributed marketing materials that are inaccurate or misleading

American Casualty Company of Reading Pennsylvania of Chicago, Ill.
Order Number: 080555
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

Bennetsen, Leslie Dawn of Victoria
Order Number: 080492
Date of Order: 6/5/2008
Order Final In: June
Action Taken: $83,701 Restitution; 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

Blue Cross and Blue Shield of Texas, A Division of Health Care Service Corporation of Chicago, Ill.
Order Number: 080514
Date of Order: 6/13/2008
Order Final In: June
Action Taken: $3,900,000 fine subject to a dollar-for-dollar reduction by restitution to $250,000
Violation: Failed to make non-preferred benefits reasonably available to its insureds; Failed to maintain an accurate listing of its preferred providers

Brown, Clinton Sloane of San Marcos
Order Number: 080538
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $1,500 fine; Must complete 30 hours of continuing education
Violation: Failed to comply with continuing education requirements

Care Improvement Plus of Texas Insurance Company of San Antonio
Order Number: 080524
Date of Order: 6/18/2008
Order Final In: June
Action Taken: $50,000 fine
Violation: Failed to timely register as a member of a holding company system; Failed to timely respond to requests for information

Caremark, L.L.C. of Northbrook, Ill.
Order Number: 080534
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $42,000 fine
Violation: Allegedly failed to timely submit annual report; Allegedly failed to timely respond to Department inquiries

Cass, Edward Ronald of Arlington
Order Number: 080541
Date of Order: 6/20/2008
Order Final In: June
Action Taken: Insurance Adjuster License revoked
Violation: Engaged in fraudulent or dishonest acts or practices; Misappropriated or converted money belonging to an insurer or insured

Conner, Charles E. of Crowley
Order Number: 080495
Date of Order: 6/5/2008
Order Final In: June
Action Taken: General Life, Accident, and Health License revoked
Violation: Felony conviction directly related to the business of insurance

Continental Casualty Company of Chicago, Ill.
Order Number: 080556
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

Daigle, Joseph M. Jr. of Killeen
Order Number: 080510
Date of Order: 6/11/2008
Order Final In: June
Action Taken: $1,500 fine; Must complete 15 hours of continuing education
Violation: Failed to comply with continuing education requirements

Dimont & Associates Inc. of El Cajon, Calif.
Order Number: 080546
Date of Order: 6/25/2008
Order Final In: June
Action Taken: Must obtain Public Insurance Adjuster licensure for all staff
Violation: Employees acted as Public Insurance Adjusters without proper licenses

Franklin, Juliana Guillen of Euless
Order Number: 080539
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $1,250 fine
Violation: Unauthorized title insurance

Givens, Jerry Michael of Abernathy
Order Number: 080543
Date of Order: 6/20/2008
Order Final In: June
Action Taken: General Life, Accident and Health License and General Property and Casualty License revoked
Violation: Felony conviction involving moral turpitude

Goldberg, Daniel Moises of Dallas
Order Number: 080542
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $16,569 Restitution; General Life, Accident and Health License and General Property and Casualty License cancelled; Waives right to re-apply for 5 years
Violation: Engaged in fraudulent or dishonest acts or practices; Misappropriated or converted money belonging to an insurer or insured

Guerrero, Omarr Tagle of Buda
Order Number: 080493
Date of Order: 6/5/2008
Order Final In: June
Action Taken: $600 fine; Must complete 15 hours of continuing education
Violation: Failed to comply with continuing education requirements

Jones, Joseph T. of Bellville
Order Number: 080544
Date of Order: 6/20/2008
Order Final In: June
Action Taken: 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; Misdemeanor conviction

McGowan, Jill Marie of Arlington
Order Number: 080509
Date of Order: 6/11/2008
Order Final In: June
Action Taken: General Life, Accident and Health Insurance Agent License denied
Violation: Felony offense directly related to the business of insurance

Mitchell County Abstract Company of Colorado City
Order Number: 080553
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $7,100 fine
Violation: Failed to timely provide an annual statistical report

National Fire Insurance Company of Hartford of Chicago, Ill.
Order Number: 080558
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

Presidio Title LLC of San Antonio
Order Number: 080535
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $2,000 fine
Violation: Provided prizes and other things of value for referals of title business

Pronto Managing General Agency LLC; Pronto MGA, LTD. of Brownsville
Order Number: 080496
Date of Order: 6/5/2008
Order Final In: June
Action Taken: Released from Cease and Desist Order

Quest Continuing Education Solutions of Brookfield, Wis.
Order Number: 080511
Date of Order: 6/11/2008
Order Final In: June
Action Taken: $3,400 fine
Violation: Taught continuing education courses without valid course certifications

Republic Lloyds of Dallas
Order Number: 080479
Date of Order: 6/2/2008
Order Final In: June
Action Taken: $10,000 fine; Must file all credit scoring models
Violation: Engaged in unfair practices; Failed to file required credit scoring models with the Department

Rico, Gesiel of San Antonio
Order Number: 080540
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $1,500 fine
Violation: Failed to comply with continuing education requirements

Sentry Insurance of Stevens Point, Wis.
Order Number: 080536
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $5,000 fine
Violation: Failed to pay independent review organization (IRO) fees on a timely basis

Simmons, Jon A. of Houston
Order Number: 080494
Date of Order: 6/5/2008
Order Final In: June
Action Taken: $585 restitution; General Life, Accident and Health License and Limited Lines License cancelled; Waives right to re-apply for 5 years
Violation: Engaged in fraudulent or dishonest acts or practices; Misappropriated or converted money belonging to an insurer or insured

Spross, Farron L. of Waco
Order Number: 080545
Date of Order: 6/23/2008
Order Final In: June
Action Taken: $5,000 fine; Must complete 2 hours of continuing education in ethics
Violation: Engaged in fraudulent or dishonest acts or practices

Stewart Title Company of Rockport Inc. of Rockport
Order Number: 080554
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $4,300 fine
Violation: Failed to timely remit title insurance policy guaranty fees

Stewart Title of the Coastal Bend, Inc. of Victoria
Order Number: 080537
Date of Order: 6/20/2008
Order Final In: June
Action Taken: $3,500 fine
Violation: Failed to timely remit title insurance policy guaranty fees

The Continental Insurance Company of Chicago, Ill.
Order Number: 080557
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

Trancontinental Insurance Company of Chicago, Ill.
Order Number: 080559
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

Transportation Insurance Company of Chicago, Ill.
Order Number: 080560
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

Trask, Reney Nicole of Houston
Order Number: 080484
Date of Order: 6/3/2008
Order Final In: June
Action Taken: General Life, Accident and Health License approved and placed on 6 years probation
Violation: Previous criminal conduct

Valley Forge Insurance Company of Chicago, Ill.
Order Number: 080561
Date of Order: 6/26/2008
Order Final In: June
Action Taken: $40,000 fine
Violation: Failed to timely provide required reconciliation forms, aggregate reports and closed claims reports

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

Was this article valuable?

Here are more articles you may enjoy.