View this article online: https://www.claimsjournal.com/news/southcentral/2010/03/15/108149.htm
Louisiana Department of Insurance fraud section investigators served a Metairie, La., agent with a six month summary suspension and fine notice for alleged misrepresentation and forgery on an insurance application. Two other Metairie agents also have been served with fine notices for misrepresentation.
Malcolm W. “Mike” McCall, 53, had his license suspended and was fined $1,500 for alleged misrepresentation and forging the signature of a client on an insurance application.
Rodolfo Benjamin Zamora, 31, and Mariano Roberto Villacorta, 36, each face $500 fines for alleged misrepresentation.
It is alleged that McCall contacted Villacorta regarding a client of his whom he thought could get a better health insurance policy with the health insurance company Villacorta and Zamora represented. Unknown to Villacorta and Zamora, the application for insurance was not completed and signed by the insured client, but by McCall himself.
During a routine claims review, the insurance company determined that pertinent medical information was omitted from the application for coverage and thus made the decision to rescind the policy retroactively to the original effective date. This decision resulted in the insured being without health insurance coverage, with outstanding medical bills and without a health policy that includes any pre-existing conditions.
Department records show that McCall holds a Life, Health and Accident license issued in September 2002 that is valid through April 2010. Records show that Zamora holds a Life, Health and Accident license issued in March 2002 that is valid through September 2012 and a Variable Contracts license issued in August 2003 that is valid through April 2010. Records show that Villacorta holds a Life, Health and Accident license issued in July 2002 that is valid through September 2012.
If McCall fails to remit payment of his fine prior to the end of the six month suspension it will result in the continuation of the suspension period until such time as the fine is paid in full. All three agents have 30 days from receipt of the notices to request a hearing with the Department to seek reversal of these decisions.
Source: Louisiana Department of Insurance