April 2018


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Peoples Trust Insurance lost $42 million in 2016, was recently in financial “shambles,” and was overvalued by more than $50 million when current President and CEO George W. Schaeffer agreed to buy half of the company from the widow of his late partner. Those claims surfaced in a memo that Schaeffer reportedly sent to Eileen Gold, widow of company co-founder Mike Gold, before he sued her for the return of $4 million he says he overpaid her.

Schaeffer and Gold are now suing each other in Palm Beach County Circuit Court.

In his suit, Schaeffer is demanding that Eileen Gold release him from his May 2014 agreement to pay $30 million for the Golds’ half of the Deerfield Beach-based company. He says an analysis conducted following Mike Gold’s death in January 2014 “grossly misrepresented” the company’s value as $88 million, but that Schaeffer later discovered it had been poorly managed and was actually worth $34 million in June 2014.

As a result, Schaeffer’s suit says, the $21 million he has so far paid to Eileen Gold was $4 million more than he should have paid. The suit demands that Eileen Gold release Schaeffer from having to pay the remaining $9 million as agreed, and repay $4 million the widow received “unlawfully” and as “unjust enrichment.”

Eileen Gold filed in both suits a memo she said Schaeffer hand-delivered on Dec. 8 — a week before the two filed their respective suits.

The memo includes the words “Privileged and Confidential Inadmissible Settlement Communication” and is headed “To: Eileen Gold. From: George Schaeffer.” It accuses Mike Gold of “mismanaging the company very badly” and hiding it from his then-partner.

“Unfortunately, I also learned that Mike spent almost every day of the week at a casino and at a massage parlor. And it appears that he was using cash from the company to finance these activities,” the memo states.

“Upon reviewing the books and records of the company, we have found that Mike had apparently engaged in CRIMINAL activity with the company, including the borrowing of funds from the insurance company. This is a crime. There are many other examples. But this company that was in supposedly good shape was actually in shambles, and lost $42 million last year alone.”

The memo then contends that an independent forensic accounting firm reviewed the prior valuation and found it was actually worth $34 million in 2014. “So the most I would have ever had to pay you was $17 million,” it says. “And yet I have already paid you $21 million; am supposed to pay you $9 million more; and on top of that I am supposed to pay you a percentage of the company if I should ever sell.

Please enjoy the full article below

http://www.sun-sentinel.com/business/fl-bz-peoples-trust-valuation-lawsuit-20180420-story.html

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Imagine filing a claim with your insurance company for hurricane damage and, months later, not only is your home not fixed, but you get served with a lawsuit by your insurance company.

Dozens of South Florida customers of Deerfield Beach-based People’s Trust Insurance are finding themselves in an unlikely and possibly unprecedented position — they’re being sued by their insurer.

Since July 1, People’s Trust has filed at least 242 lawsuits against its policyholders in Miami-Dade, Broward and Palm Beach counties, according to court records. Of those, 161 have been filed since Nov. 17, a day after the Sun Sentinel first reported the strategy.

The new suits include 113 against the company’s customers in Miami-Dade, 38 in Broward and 10 in Palm Beach County.

Attorneys for some of the defendants accuse the company of using the suits to bully their clients into accepting subpar repairs — and punish them for securing help from lawyers and independent public adjusters.

When People’s Trust decides to sue a customer, it’s intimidating, especially for people who have never been involved in a suit, said Anthony Lopez, a Coconut Grove-based attorney who specializes in insurance litigation.

Anthony Tinelli, a Miami attorney who formerly worked as a defense attorney for People’s Trust, said he’s representing seven Hurricane Irma victims who were recently sued by the company. “For one insurance company to sue its homeowners to that extent is unprecedented,” he said.

Another Miami-based attorney, Rafael Alonso, attributed the recent surge in lawsuits by the company to disputes over Hurricane Irma claims. “I’ve never seen an insurance company, especially after a natural disaster, suing its insureds,” he said.

People’s Trust says the attorneys and public adjusters generate disputes by preventing the company from sending its affiliated repair contractor — Rapid Response Team — to fix customers’ homes, as the customers agreed to allow when they signed up with the insurer. In exchange, policyholders were given a discount off their premiums, usually totaling $200 or less, the suits state.

People’s Trust and Rapid Response Team are both among a suite of related companies owned by entrepreneur George W. Schaeffer.

Please read the full article below

http://www.sun-sentinel.com/business/fl-bz-peoples-trust-insurance-sues-100-more-customers-20180419-story.html

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A Florida man has been sentenced to more than a year in prison for his role in a $23 million auto insurance fraud involving chiropractors’ clinics.

The SunSentinel reports 55-year-old Jason Dalley wept in court April 16 as a judge sentenced him to spend a year and nine months in prison and pay more than $1.8 million in restitution

Dalley admitted he was part of a group of clinic owners, chiropractors and attorneys involved in the scheme. Court records show the fraud involving clinics in Broward, Palm Beach and Miami-Dade counties brought in at least $23 million from 10 insurance companies between 2010 and 2017.

Dalley ran a personal injury and criminal defense law firm in Boca Raton. He pleaded guilty to conspiring to commit health care, mail and wire fraud.

Please enjoy the full article below;

https://www.insurancejournal.com/news/southeast/2018/04/20/486981.htm

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An insurance agency owner in Florida has been arrested after he admitted to stealing more than $60,000 in insurance premiums, according to a statement from the Florida Department of Financial Services (DFS).

Michael Christopher Hensley, owner BOSC Insurance Company and Hensley Insurance Company, admitted to stealing $61,954 in insurance premiums between 2011 and 2018 in Orange County, Fla

The theft was discovered after an investigation by the DFS Disaster Fraud Action Strike Team (DFAST) revealed that Hensley had solicited various commercial businesses to procure property and casualty insurance under both of his companies BOSC and Hensley Insurance. Hensley has had no active appointments on his license since 2010, making his licensed expired as of 2014 and unlicensed as of March 9, 2015.

After the impacts of Hurricane Irma, a commercial business property sustained extensive damage caused from the storm. The business owner attempted to contact his insurance agent, Hensley, for guidance on the claim process. After multiple calls and no response from Hensley, the owner contacted the listed insurance carrier on the Certificates of Insurance that Hensley had been providing the business with annually since 2012. An insurance representative with the listed company informed that the business was not insured with them nor had he ever been insured with the insurance company. Upon this revelation, the owner of the business contacted the CFO’s Orlando Field Office for assistance.

As a result of the DFS investigation, Hensley admitted to collecting monthly insurance premiums payments from nine different commercial business and providing them with false Certificates of Insurance coverage. Hensley went to various insurance company’s websites and made copies of their general liability policies. He would then take the companies information and transfer it to Certificates of Insurance and provide the fraudulent documents to the unsuspecting businesses as proof of insurance. Hensley further admitted to using the money that he obtained from the victim businesses for his own personal benefits

Please enjoy the full article below;

https://www.insurancejournal.com/news/southeast/2018/04/19/486791.htm

 

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Florida Chief Financial Officer Jimmy Patronis has released a top 10 list of most wanted insurance fraud criminals and called on local communities to help with finding the individuals.

According to a statement from the Florida Department of Financial Services, each of the following individuals is wanted for various insurance-fraud related crimes:

  • Anthony Fitzgerald Phillips, last known address Fullerton, Calf.: Grand Theft.
  • Huberto Del Sol Puerto, last known address Hialeah/Miami, Fla.: Organized fraud ($50,000 or More), false and fraudulent insurance claims, grand theft (3rd Degree), money laundering, false statement (Jurisdiction of Department of State).
  • Gabriel Sanchez, last known address Miami, Fla.: Racketeering.
  • William Brenes, last known address Hillsborough County: Fraudulently presenting a false statement ($100,000 or more).
  • Jose Alexis Orellana Ramos, last known address North Lauderdale, Fla.: Organized fraud ($50,000 or more), grand theft (1st Degree, $100,000 or more), workers’ compensation fraud (Over $100,000).
  • Joseph J. Beckford, last known address Carrollton, Ga.: False and fraudulent insurance claim.
  • Bernardo Romero-Ortiz, last known address Orlando, Fla.: Workers’ compensation fraud ($100,000 or more); organized fraud.
  • Roland Terencio Delgado, last known address Coral Gables, Fla.: Racketeering, grand theft (2 Counts).
  • Paul Emmanuel Pierre, last known address Orlando, Fla.: Racketeering, false and fraudulent insurance claim.
  • Javier Lopez Rivero, last known address Miami, Fla.: Racketeering, grand theft, false and fraudulent insurance claims.

Please enjoy the full article below

https://www.insurancejournal.com/news/southeast/2018/04/18/486707.htm

 

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Citizens Property Insurance Corp. has approved a slate of policy language changes designed to protect consumers while addressing rising costs of nonweather water loss claims and related litigation that continue to drive premiums higher, according to a statement from the state-run insurer of last resort.

The policy changes will also address issues that have arisen since the Citizens Managed Repair Program was enacted last year and a subsequent rise in litigation the company says has occurred as a result.

The proposed policy changes, approved by unanimous vote at the Board of Governors meeting on Wednesday, would boost incentives for policyholders to participate in Citizens Managed Repair Program while better ensuring that customers who choose not to participate have adequate funds to make permanent repairs following a nonweather related water loss.

The new policy language would limit payment on nonweather related water losses – a broken pipe, a leaking water heater – to $10,000, including $3,000 for emergency water mitigation services. Additional water mitigation exceeding the $3,000 limit would be completed by Citizens managed repair contractors at no cost to the policyholder. The changes would take effect Aug. 1, 2018, if approved by the Florida Office of Insurance Regulation.

Please enjoy the full article below,

https://www.insurancejournal.com/news/southeast/2018/04/12/486137.htm

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In another step shifting risk to private markets, the Federal Emergency Management Agency (FEMA) said it intends to secure additional reinsurance for the National Flood Insurance Program (NFIP) through issuance of a catastrophe bond.

FEMA began purchasing private reinsurance in 2017 and recovered $1.042 billion from the private markets due to losses from Hurricane Harvey. In early January 2018, FEMA continued the practice by securing $1.46 billion in reinsurance from 28 private reinsurers to cover any qualifying NFIP flood losses in excess of $4 billion per event occurring in calendar year 2018.

FEMA said it now plans to transfer additional risk by engaging the capital markets for the first time through an insurance-linked securities (ILS) transaction on or about July 1, 2018.

Adding this new resource will enable FEMA to transfer risk through two avenues – the traditional reinsurance markets and the capital markets. Wright said that using both markets will create more competition and reduce the NFIP’s risk transfer costs. It will also enable FEMA to access greater market capacity and spread its risk across a more diverse pool of companies and investors, according to the announcement.

“The NFIP requires a stronger financial framework built on expanding our portfolio of actuarially-priced policies. Transferring more of the risk burden to the private capital markets continues to be part of that strategy,” said Roy Wright, director of the NFIP.

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https://www.insurancejournal.com/news/national/2018/04/05/485448.htm