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2018 Division of Insurance Enforcement Activity

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Please Note: P.L. 2013, c. 259 became effective on July 1, 2014.  This law amended the Administrative Procedure Act, R.S. 52:14B-1 et seq. One of the amendments requires all state agencies to post on their websites all non-confidential final agency orders, decisions and opinions. Accordingly, all such final agency orders or decisions in disciplinary actions issued subsequent to July 1, 2014 may be accessed by clicking on the link within the summaries below. Orders or decisions issued on such matters prior to July 1, 2014 are available upon request to the Division of Insurance.
 
May

Final Orders

Bienvenido Dominguez, West New York, NJ
Dominguez Agency LLC, North Bergen, NJ
Order #E18-55, May 31, 2018
Respondents failed to respond to an Order to Show Cause charging them with failing to remit premiums for five clients and failing to respond to Department inquiries.    
Sanction: Revocation, Fine - $15,000, Costs - $825

William M. Kwasnik, Miami, FL
Order #E18-40, May 1, 2018
Respondent participated in a fraudulent scheme involving the sale of unregistered securities, failed to advise the Commissioner that a Consent Order and Final Judgment was entered against him by the Bureau of Securities and misstated on his license renewal application that he was not the subject of any administrative proceedings.
Sanction: Revocation, Fine - $25,000

Shannon Shaw, Glassboro, NJ
Order #E18-50, May 25, 2018
Respondent failed to respond to an Order to Show Cause charging her with being convicted of third-degree Insurance Fraud and with failing to report the charges and conviction to the Commissioner.
Sanction: Revocation, Fine - $5,000, Restitution - $6,105, Costs - $900

Brian Tripp, Clayton, NJ
Order #E18-43, May 18, 2018
Respondent failed to respond to an Order to Show Cause charging him with directly soliciting for Medicare Advantage plans and making material misrepresentations on the application forms.
Sanction: Revocation, Fine - $25,000, Costs - $2,200


Orders to Show Cause

Mark Jiorle, Franklin Park, NJ
Order #E18-53, May 25, 2018
Respondent is charged with disclosing a change of beneficiary on a life insurance policy to a person who was not the policy owner.  

Paul B. Kumar, North Brunswick, NJ
Order #E18-54, May 25, 2018
Respondent is charged with submitting 16 applications for insurance without the knowledge or consent of the applicants and forging the applicants’ signatures on the applications.

Manuel Moreno, Perth Amboy, NJ
On Time Bail Bonds LLC, Perth Amboy, NJ
Order #E18-51, May 25, 2018
Respondents are charged with multiple instances of misappropriation of bail bond premium.

Hany Shehata, West Orange, NJ
Order #E18-52, May 25, 2018
Respondent is charged with failing to timely return a premium refund, failing to advise a policyholder that his policy had been cancelled and failing to maintain a trust account.


Consent Orders

Richard Almanzar, Jersey City, NJ
Order #E18-48, May 25, 2018
Respondent permitted someone other than the insured to sign the insured’s name on an insurance application.
Sanction: Fine - $1,000

Marta Cristina Cunha, Union, NJ
Order #E18-46, May 25, 2018
Respondent submitted seven applications for life insurance without the knowledge or consent of the applicants, impersonated the applicants during telephone interviews with the insurer, was convicted of theft by deception and failed to report her indictment and conviction to the Department.
Sanction: Revocation, Fraud Act Fine - $2,500, Fraud Act Surcharge - $125

Charles D. Melitta, Fair Haven, NJ
Order #E18-41, May 12, 2018
Respondent incorrectly answered the question on his license renewal application about proceedings taken against him by other state insurance departments and failed to notify the Department of an action taken against him by another state insurance department.
Sanction: Fine - $2,000
               
Juan V. Papadopulos, Paterson, NJ
Exclusive Financial Services, Paterson, NJ
Order #E18-42, May 18, 2018
Respondent submitted an application to the New Jersey Personal Automobile Insurance Plan for a person who did not have a valid New Jersey driver’s license.
Sanction: Fine - $2,500

Arthur Sinuk, New York, NY
Order #E18-47, May 25, 2018
Respondent misrepresented the source of funding for two insurance policies and the city and state in which the applications were signed and conspired with the applicants to reimburse their life insurance premiums.
Sanction: Revocation, Fraud Act Fine - $5,000, Fraud Act Surcharge - $250

Gail Elizabeth Six, Howell, NJ
Order #E18-49, May 25, 2018
Respondent misrepresented herself as the insured in a telephone call with the insurer during which she submitted a claim for preexisting damage.
Sanction: Revocation

 
April

Orders to Show Cause

Avelino C. Andrade, Monroe, NJ
Order #E18-36, April 20, 2018
Respondent is charged with misappropriating and failing to remit premium, issuing checks for the payment of premium that were dishonored by his bank for insufficient funds, failing to maintain a trust account and failing to maintain copies of receipts for premium payments.

Robert Lapinski, Little Ferry, NJ
Cutting Edge Bail Bonds, LLC, Little Ferry, NJ
Dollar Bail Bonds, Inc. d/b/a Dollar Bail Bonds, Little Ferry, NJ
Order #E18-33, April 19, 2018
Respondents are charged with misrepresentation of the terms of an insurance agreement, forgery and failing to satisfy a judgment for wrongfully attempting to collect premiums and costs relating to a bail bond.

Karen Yokely, Plainfield, NJ and Somerville, NJ
Isatu Tejan-Se, Long Branch, NJ and West Long Branch, NJ
Order #E18-39, April 30, 2018
Yokely is charged with conviction of conspiracy to commit wire fraud for her role in a fraudulent mortgage loan scheme and with failing to report her indictment and an action taken against her by another insurance Department.  Tejan-Se is charged with failing to report her indictment.


Consent Orders

Advanced Health Partners, Inc., New Windsor, NY
Order #E18-28, April 10, 2018
Respondent conducted business as a third party billing service prior to being certified as a third party billing service by the Commissioner.
Sanction: Fine - $1,000.

Jerod Blakestad, Minneapolis, MN
Capitol Risk Insurance Advisors Inc., Minneapolis, MN
Order #E18-37, April 24, 2018
Respondent solicited surplus lines policies prior to obtaining surplus lines authority and charged fees without issuing a separate fee agreement.
Sanction: Fine - $10,000.

Clements & Company, Washington, DC
Underwriters at Lloyd’s, London, Syndicate 0303, Tokio Marine Kiln Syndicates Limited, London, UK
Underwriters at Lloyd’s, London, Syndicate 3622, Beazley Furlonge Limited, London, UK
UNFCU Financial Services LLC, Long Island City, NY
Order #E18-27, April 6, 2018
Respondents sold term life insurance underwritten by an unauthorized insurer.
Sanction: Clements & Company, Fine - $60,000
                Underwriters at Lloyd’s, London, Syndicates 0303 and 3622, Fine - $60,000
                UNFCU Financial Services LLC, Fine - $60,000.

Alicia M. Jones, Newark, NJ
Order #E18-38, April 24, 2018
Respondent was convicted of a felony involving breach of trust or dishonesty, did not obtain a 1033 waiver from the Commissioner and failed to report her indictment and conviction.
Sanction: Revocation, Fine - $1,000.

Scott D. Lever, North Caldwell, NJ
All Jersey Title, LLC, Caldwell, NJ
Order #E18-29, April 10, 2018
The agency’s employee sent emails offering an inducement to the purchase of title insurance.
Sanction: Fine - $2,500.

McSweeney Agency, LLC, Mount Laurel, NJ
Order #E18-31, April 17, 2018
Respondent accepted business from, placed insurance policies for and paid commissions to an unlicensed producer.
Sanction: Fine - $25,000.

Mercury Indemnity Company of America, Clearwater, FL
Order #E18-30, April 16, 2018
Respondent conducted business with and paid commissions to an unlicensed producer.
Sanction: Fine - $25,000.

 
March

Final Order

Travis Hansberger, Eagan, MN
Order #E18-14, March 3, 2018
Respondent’s application for an initial nonresident producer application is denied due to his conviction for criminal sexual conduct.


Orders to Show Cause

John P. DeStefano, Caldwell, NJ
Order #E18-24, March 28, 2018
Respondent is charged with submitting a homeowners insurance application without the applicant’s knowledge or consent, forging the applicant’s signature on the application and related documents, submitting a forged application to the Department and failing to refund the full premium to the applicant.

Sherrica Octavia McDonald, Neptune, NJ
Octavia Global Investment, LLC d/b/a Octavia Bail Bonds, Neptune, NJ
Order #E18-22, March 19, 2018
Respondents are charged with failing to remit premiums, failing to establish and maintain a trust account, failing to return unused powers of attorney, failing to maintain accurate books and records, issuing a check that was returned for non-sufficient funds and failing to make contributions to a build up fund.

Clifford Moss, New York, NY, Brooklyn, NY and Staten Island, NY
Order #E18-23, March 20, 2018
Respondent is charged with misrepresenting information on annuity applications as to where the sales occurred and where the applications were signed, forging signatures of insureds on letters to the insurer to cover up the misrepresentations and committing insurance fraud.

Kenneth J. Murphy, Hamburg, NJ
Order #E18-17, March 5, 2018
Respondent is charged with submitting applications for fictitious policies to an insurer and providing inaccurate, forged or false information to the insurer.

Brian Tripp, Clayton, NJ
Order #E18-20, March 13, 2018
Respondent is charged with directly soliciting for Medicare Advantage plans and making material misrepresentations on the application forms.


Consent Orders

Jesica Y. Lee, Fort Lee, NJ
Jesica Lee Insurance Agency, Inc., Palisades Park, NJ
Order #E18-21, March 9, 2018
Respondents allowed an unlicensed employee to issue automobile insurance quotes and to alter resident addresses on automobile policies to obtain lower premiums.
Sanction: Fine - $5,000.

Steven R. Lodovico, Ellwood, PA
Order #E18-15, March 2, 2018
Respondent issued a misleading advertisement, changed address without notifying the Department and failed to respond to a Department inquiry.
Sanction: Fine -$2,500.

Philip Albert McClendon, Grass Valley, CA
Citizens General Insurance Brokers, Inc., Auburn, CA
Order #E18-19, March 9, 2018
Respondents charged fees without entering a separate written fee agreement.
Sanction: Fine - $5,000.

Property Title Group LLC, Parsippany, NJ
Order #E18-16, March 2, 2018
Respondent employed a producer whose license was revoked.
Sanction: Fine - $2,500.

 
February

Orders to Show Cause

Magdalena Guzman, Perth Amboy, NJ and Fort Myers, FL
Order #E18-07, February 7, 2018
Respondent is charged with submitting insurance applications for fictitious employees, with forging employer signatures on insurance forms, and with failing to respond to Department inquires and a Department subpoena.

James V. Mascola,
Bridgeton, NJ
Genevieve Steward, Glassboro, NJ
Bail Group Management, LLC, Millville, NJ
East Coast Bail Bonds, LLC, Millville, NJ
Order #E18-08, February 7, 2018
Respondents are charged with failing to remit premiums for bail bonds, with failing to timely return collateral for bail bonds, with misappropriation of bail bond collateral, with conducting business through a business entity that was not licensed as a producer, with failing to register a branch office and with failing to respond to Department inquiries.


Consent Orders

Americhoice of New Jersey, Inc., Edison, NJ
Oxford Health Insurance, Inc., Shelton, CT
Oxford Health Plans (New Jersey) Inc., Shelton, CT
UnitedHealthcare Insurance Company, Hartford, CT
Order #E18-12, February 22, 2018
Respondents used an entity for the provision of hemophilia supplies and services that lacked the required state designation and improperly required member consent for provider payment appeals.  Americhoice of New Jersey, Inc. failed to promptly comply with decisions of the Independent Health Care Appeals Program that reversed its denials of authorization and claims.   Oxford Health Insurance, Inc. failed to provide utilization management appeal rights to persons covered by individual health benefits plans who sought an override of a prescription drug quantity limit and provided incorrect information to callers and on its website about the individual health benefits plans it offered in New Jersey.
Sanction: Fine - $2,500,000.

Ryan Patrick O’Connor,
La Jolla, CA
Prospect General Insurance Agency, Inc., La Jolla, CA
Order #E18-11, February 14, 2018
Respondents bound a surplus lines policy prior to becoming licensed to sell surplus lines insurance and charged fees without entering a separate written fee agreement.
Sanction: Fine - $3,000.

R&S Electronic Medical Billing, LLC,
Belleville, NJ
Order #E18-09, February 8, 2018
Respondent acted as a third party billing service prior to being certified as a third party billing service.
Sanction: Fine - $1,000.

Enrico Smith,
Clayton, NJ
Earline Princewill, Clayton, NJ
Order #E18-06, February 7, 2018
Respondent Smith solicited insurance for a company with whom he was not appointed and Respondent Princewill signed the applications solicited by Respondent Smith even though she was not involved in the solicitation or sale.
Sanction: Fine - $10,000.

 
January

Consent Orders

Carmine Fusco, Bloomfield, NJ
Order #E18-05, January 17, 2018
Respondent was convicted of mortgage fraud for willfully aiding a mortgage fraud scheme.
Sanction: Revocation, Fine - $1,500.

Howard M. Liu, Newark, DE
Order #E18-01, January 3, 2018
Respondent sold an insurance policy when his license was expired and failed to report a FINRA suspension to the Department.
Sanction: Revocation.

Gary B. Sutherland, Framingham, MA
North American Professional Liability Insurance Agency, Framingham, MA
Order #E18-02, January 9, 2018
Respondent charged fees without obtaining a required written fee agreement.
Sanction: Fine - $5,000.

 
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