Law & Ethics Update1

Regulatory Awareness

 

 

 

Jurisdiction of Duties and Responsibilities

 

Chief Financial Officer of Florida

The Chief Financial Officer is the chief fiscal officer of the state and is responsible for settling and approving accounts against the state and keeping all state funds and securities.  The Chief Financial Officer of Florida is a statewide constitutional officer of Florida. The office was created in 2002 following the 1998 reforms of the Florida Cabinet.

The CFO is a combination of the former offices of
Comptroller and Treasurer/Insurance Commissioner/Fire Marshal. The office heads the Florida Department of Financial Services and is responsible for overseeing the state's finances, collecting revenue, paying state bills, auditing state agencies, regulating cemeteries and funerals, and handling fires and arsons. In addition, the CFO has administrative oversight over the offices which handle banking and insurance regulation. The CFO is a member of the Cabinet.

 

The Chief Financial Officer (CFO) of the Florida Department of Financial Services is an elected position, which requires living in Florida and provides an office in the Capitol building. The current CFO began his 4-year term in January 2011, and the election process was not new this man who has served the public since 1993.

 

Title IV, Chapter 17 (Executive Branch: Chief Financial Officer) of the Florida Statutes is dedicated to the operations of the CFO. The responsibilities are grand in scope, and that of which you need to be keenly aware is the office of the CFO supervises insurance consumer services, licensing, and oversight of insurance agents and agencies. Insurance fraud investigation is overseen by the CFO, as well as ensuring businesses have workers' compensation coverage in place for employees, and helping injured workers with benefit payments and re-employment.

 

 

 

DEPARTMENT OF FINANCIAL SERVICES

 

Florida Department of Financial Services (FLDFS) is a state agency of Florida. Its headquarters are in Tallahassee.  In 2002 the Florida Legislature merged the Department of Insurance, Treasury and State Fire Marshal and the Department of Banking and Finance into one department, the Florida Department of Financial Services.

 

The Department is led by the Chief Financial Officer of Florida (CFO), who is elected statewide to a four year term. The CFO is assisted in running the Department by two Deputy Chief Financial Officers and a Chief of Staff. The Department is organized into 13 functional Divisions, which perform the work of the Department, and 7 Offices, which assist the CFO in managing the Department and fulfilling the CFO's responsibilities.  [Source: Florida Statute §20.121]

  

The Division of Accounting and Auditing:
1. Bureau of State Payrolls;
2. Bureau of Financial Reporting;
3. Bureau of Auditing; and
4. Bureau of Vendor Relations.

The Division of Administration:
1. Bureau of General Services;
2. Bureau of Human Resource Management; and
3. Office of Publications.
4.The Office of Cabinet Affairs.

The Office of Communications.

The Division of Consumer Services:
1. Bureau of Education Advocacy and Research; and
2. Bureau of Consumer Assistance.

The Office of Finance and Budget, including its Bureau of Financial Services.

The Division of Funeral, Cemetery, and Consumer Services

 The Office of the General Counsel (formerly the Division of Legal Services).

The Division of Information Systems (do not refer to as Information "Services").

The Division of Insurance Agent and Agency Services
1. Bureau of Investigation; and
2. Bureau of Licensing.

The Division of Investigative and Forensic Services
1. The Bureau of Forensic Services
2. The Bureau of Fire and Arson Investigations
3. The Office of Fiscal Integrity
4. Bureau of Workers' Compensation Fraud;
5. Bureau of Insurance Fraud; and
6. Operational Support Services.

The Office of Inspector General.

The Office of Insurance Consumer Advocate.

The Office of Internal Affairs and Appointments.

The Office of Legislative Affairs.

The Office of Program Management.

The Division of Public Assistance Fraud.

The Division of Rehabilitation and Liquidation.

The Office of Research and Planning.

The Division of Risk Management:
1. Bureau of Risk Financing and Loss Prevention;
2. Bureau of State Employee Workers' Compensation Claims; and
3. Bureau of State Liability and Property Claims.

The Division of State Fire Marshal:
1. Bureau of Fire Prevention; and
2. Bureau of Fire Standards and Training.

The Division of Treasury:
1. Bureau of Deferred Compensation;
2. Bureau of Collateral Management; and
3. Bureau of Funds Management.

The Division of Unclaimed Property

The Division of Workers’ Compensation:
1. Bureau of Financial Accountability;
2. Bureau of Monitoring and Audit, including its Medical Services Section
3. Bureau of Employee Assistance and Ombudsman Office;
4. Bureau of Compliance; and
5. Bureau of Data Quality and Collection

Offices are maintained at the State Capitol in Tallahassee and around the state as designated.  [Source: Florida Statute §624.302]

 

 

Office of Insurance Regulation

 

The Financial Services Commission consists of the Governor, Attorney General, Chief Financial Officer, and Commissioner of Agriculture. Commission members serve as the agency head of the Financial Services Commission. Commission actions are decided by majority votes consisting of at least three affirmative votes. The commission is not subject to control, supervision, or direction by the Department of Financial Services and is a completely separate budget entity. One of the offices established by the commission is Florida’s Office of Insurance Regulation.

 

The Office of Insurance Regulation has primary responsibility for regulation, compliance and enforcement of statutes related to the business of insurance and the monitoring of industry markets. Is also responsible for all activities concerning insurers and other risk bearing entities, including licensing, rates, policy forms, market conduct, claims, issuance of certificates of authority, solvency, viatical settlements, premium financing, and administrative supervision, as provided under the insurance code or chapter 636. The head of the Office of Insurance Regulation is the Director of the Office of Insurance Regulation, who may also be known as the Commissioner of Insurance Regulation.

Bureaus within the Division are organized into centers of regulatory expertise related to life and health, property and casualty, specialty lines and other regulated insurance entities. It is within the Division of Insurer Services that the mission of public protection is implemented through regulatory oversight of company solvency, policy forms and rates, market conduct performance and new company entrants to the Florida market.
[Source: §620.121(3)(a)(1)]

 

 

Office of Financial Regulation

 

The Financial Services Commission also established the Office of Financial Regulation (OFR). The OFR is responsible for all activities relating to the regulation of banks, credit unions, other financial institutions, finance companies, and the securities industry. The head of the office is known as the Director or Commissioner of Financial Regulation. The OFR includes a Bureau of Financial Investigations, which functions as a criminal justice agency for investigating and enforcing Florida laws applicable to the office. The bureau operates on a separate budget, in part due to conducting investigations within or outside Florida, as necessary, to aid in enforcement and conduct of their duties. If, during an investigation, the office has reason to believe that any criminal law of Florida has or may have been violated, the office refers any records identifying the alleged violation to state or federal law enforcement or prosecutorial agencies and provides investigative assistance to those agencies as required.

[Source: §20.121(3)(a)(2)]

 

 

 

Licensing Requirements

 

Individual License

 

A license and appointment is required in order to engage in the solicitation of insurance in Florida. (An appointment is the authority given by an insurer or employer to a licensee to transact insurance or adjust claims on their behalf.) Solicitation of insurance is an attempt to persuade any person to purchase an insurance product by:

 

· Describing the benefits or terms of insurance coverage, including  premiums or rates of return

· Distributing an invitation to contract to prospective purchasers

· Making general or specific recommendations as to insurance products

· Completing orders or applications for insurance products

· Comparing insurance products, advising as to insurance matters, or  interpreting policies or coverages, or

· Offering or attempting to negotiate on behalf of another person a viatical settlement

· Performing these acts of solicitation without a license from the  department and appointment by an appropriate appointing entity or individual is fraudulent and defies Florida statute. Specifically:

 

· No one can hold himself or herself out to be an agent, service representative, customer representative, or limited customer representative without first securing the appropriate license and appointment

· No one can hold himself or herself out to be a service representative  unless he or she holds a current, effective service representative license    and appointment.

· No one can hold himself or herself out to be a managing general agent unless he or she holds a current, effective managing general agent license and appointment.

· An individual employed by a life or health insurer as an officer or other salaried representative may solicit and effect contracts of life insurance or annuities or of health insurance, without being licensed as an agent,      when and only when he or she is accompanied by and solicits for and on   the behalf of a licensed and appointed agent.

 

Even those holding a license to sell insurance are restricted to selling only the products for which their license includes. Similarly, an adjuster may not act in an adjuster’s capacity as to any class of business for which he or she is not already licensed and appointed.  [Source: §626.112]

 

The department will provide all forms for the termination and application of all licenses and appointments.
[Source: §626.161]

 

 

 

Application for a license

 

The department will not issue a license (as agent, customer representative, adjuster, service representative, managing general agent, or reinsurance intermediary) to anyone unless a written application is filed with the department, and meets the qualifications for the license applied for, and nonrefundable, prepayment is made for applicable fees. The application must be made under oath and signed by the applicant. If an applicant permits a third party to complete, submit, and sign an application on the applicant’s behalf, he or she is still responsible for ensuring the information provided is true, correct, and accountable for any misstatements or misrepresentations.


An applicant for a license (as an agent, customer representative, adjuster, service representative, managing general agent, or reinsurance intermediary) must submit a set of fingerprints, or, if the applicant is not an individual, a set of the fingerprints of the sole proprietor, majority owner, partners, officers, and directors, and must pay the fingerprint processing fee. Fingerprints are used to investigate the applicant’s qualifications. The fingerprints are taken by a law enforcement agency, designated examination center, or other department-approved entity.

[Source: §626.171]

 

 

Number of applications for a licensure require

 

After a license has been issued, the individual is not required to take another examination for a similar license, regardless, in the case of an agent, of the number of insurers to be represented by him or her as agent, unless: 

 

· Specifically ordered by the department to complete a new application; or

· During any period of 48 months since the filing of the original license application, the individual was not appointed as an agent, customer representative, or adjuster, unless the failure to be so appointed was due to military service, in which event the period within which a new application is not required may, at the discretion of the department, be extended to 12 months following the date of discharge from military service if the military service does not exceed three years, but in no event to extend under this clause for a period of more than six years from the date of filing of the original application for license. [Source: §626.181]

 

 

Qualifications for License


The department will not issue a license as a life agent to anyone found to be untrustworthy or incompetent, or who does not meet the following qualifications: 

· Must be a natural person of at least 18 years of age.

· Must be a United States citizen or legal alien who possesses work authorization from the United States Bureau of Citizenship and Immigration Services and a bona fide resident of Florida.

· Must not be an employee of the United States Department of Veterans Affairs or state service office.

· Must not be a funeral director, its employee or representative, or have an office in, or in connection with a funeral establishment, except that a funeral establishment may contract with a life insurance agent to sell a preneed contract. This agent may sell limited policies of insurance covering the expense of final disposition or burial of an insured in an amount not to exceed $12,500, adjusted annually for inflation. However, a funeral director, a direct disposer, or an employee of a funeral establishment that holds a certificate of authority can obtain an agent’s license to sell only policies of life insurance covering the expense of a prearrangement for funeral services or merchandise, and to provide funds at the time the services and merchandise are needed.

· Must take and pass any required examination for license.

· Must be qualified as to knowledge, experience, or instruction in the business of insurance and meet the necessary requirements.

· An individual who is a bona fide resident of Florida meets the residence requirement, even if a license in his or her name is on record in another state, as a resident licensee of that state, if the applicant furnishes a letter of clearance satisfactory to the department that the resident    licenses have been canceled or changed to a nonresident basis and that         he or she is in good standing. [Source: §626.785]

 

 

 

Appointment

“Appointment” means the authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf of an insurer or employer. [Source: §626.051(3)]

In order to advertise or act as an insurance agent or a customer representative, they must be currently licensed by the department and appointed by an appropriate entity or person. Any person who knowingly transacts insurance or insurance activities without a license commits a third degree felony.

Effective October 1, 2015, the department must automatically convert the registration of an approved registered insurance agency to an insurance agency license. [Source: §626.112]

 

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