ALJDEC decisions subject to certification as final

21A-038-INS · Department of Insurance and Financial Institutions - Insurance · 2021-09-20

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

In the Matter of:

COUGHLIN, JAMES

(National Producer No. 6733043)

Respondent

No. 21A-038-INS

ADMINISTRATIVE LAW JUDGE DECISION

HEARING: September 9, 2021

APPEARANCES: Respondent James Coughlin did not appear. The Arizona Department of Insurance was represented by Assistant Attorney General Holly Wan.

ADMINISTRATIVE LAW JUDGE: Adam D. Stone

_____________________________________________________________________

FINDINGS OF FACT

At all times relevant to this matter, James Coughlin (Respondent) was licensed by the Arizona Department of Insurance (Department) in Arizona as a resident insurance producer with lines of authority in life insurance and accident and health or sickness insurance. National Producer Number 6733043. Respondent’s license was scheduled to expire on February 28, 2025.

On or about February 11, 2021, Raymond Ramirez (“Ramirez”) submitted a consumer complaint (“Complaint”) to the Department alleging that Respondent created two term life insurance policies as well as two term life insurance policies for his wife, Emily Lippert (“Lippert”) without their consent or knowledge.

On or about February 16, 2021, the Department spoke with Ramirez and Lippert regarding the Complaint. Lippert informed the Department that when she and Ramirez were married in April 2019, Ramirez cancelled his insurance policies with Respondent and was added to Lippert’s insurance coverage. Further, during the conversation, Lippert informed the Department that Respondent would constantly call her and Ramirez to try to sell them new policies, despite informing Respondent that they were not interested. In June 2019, Lippert requested that Respondent stop calling and Respondent became angry.

Lippert also informed the Department that in July 2020, when reviewing Ramirez’s bank statements, she noticed recurring charges from National General Insurance Company (“NGIC”). Lippert then investigated the charges and became aware that four term life insurance policies were created with NGIC and the premiums were being auto-drafted from Ramirez’s bank account. Two of the policies were created in 2019 after the last phone call with Respondent, and the other two were created in 2020.

At hearing, the Department offered the testimony of Wendy Greenwood and offered14 exhibits into evidence.

Ms. Greenwood was the Department’s Investigations Supervisor and investigated this matter once the former Investigator Jeff Eavenson left the Department.

Ms. Greenwood testified as to the above and detailed the four policies in question. First, Ms. Greenwood demonstrated in Exhibit 3 how Ramirez’s address was incorrect and the e-mail address was that of Respondent’s. Second, Ms. Greenwood testified that Exhibit 7 was another policy with Ramirez are the primary insured and again Ramirez’s address and e-mail address was incorrect. All policies were purported to be e-signed by Ramirez.

As to the two policies with Lippert as the primary insured, again the address and e-mail address was incorrect on both, but also the name of the primary insured was incorrect. Further, both policies were purported to be e-signed by “Emily Ramirez”. Ms. Greenwood testified that during her conversation with Lippert, she was informed that Lippert never changed her name to “Ramirez” upon marriage, so she never would have used that name on an insurance application.

Ms. Greenwood testified further that NGIC also investigated the matter and provided records to Investigator Eavenson to assist in the Department’s investigation. NGIC also cancelled all four policies and refunded the paid premiums to Ramirez and Lippert.

In addition, Ms. Greenwood testified that Investigator Eavenson sent e-mail correspondence to Respondent on March 18, 2021 requesting Respondent schedule a time for an interview.

Ms. Greenwood then testified that Respondent replied later that day and denied the allegations, but was unresponsive to the request for an interview. Further, Ms. Greenwood testified that Respondent also ignored the Department’s two subpoenas to appear for an interview.

Finally, the Department argued that due to Respondent’s actions his license should be revoked.

Respondent did not appear at the hearing; therefore, he did not present any evidence to refute or rebut the evidence presented by the Department.

CONCLUSIONS OF LAW

This matter is a disciplinary proceeding wherein the Department must prove by a preponderance of the evidence that Respondent violated the State’s Insurance Laws. See A.A.C. R2-19-119.

The copies of the Notice of Hearing that the Department sent to Respondent at his address of record and at his email address of record were reasonable and Respondent is deemed to have received notice of the hearing. A.R.S. §§ 41-1092.04 and 41-1092.05(D).

Respondent’s conduct, as described above, constituted using fraudulent, coercive or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business, within the meaning of A.R.S. § 20-295(A)(8).

Respondent’s conduct, as described above, constituted forging another’s name to any document related to an insurance transaction, within the meaning of A.R.S. § 20-295(A)(10).

Respondent’s conduct, as described above, constituted knowingly presenting, causing to be presented or preparing with the knowledge or belief that it will be presented, an oral or written statement, including computer generated documents, to an insurer that contains untrue statements of material fact or that fails to state any material facts with respect to the application for the issuance of an insurance policy, within the meaning of A.R.S. § 20-463(A)(1)(a).

Grounds exist for the Director of the Department to suspend, revoke, or refuse to renew the License pursuant to A.R.S. § 20-295(A).

Further, Respondent’s failure to appear at the hearing demonstrates that he is not able to be regulated at this time.

ORDER

Based upon the above, Respondent’s License shall be revoked on the effective date of the Order entered in this matter.

In the event of certification of the Administrative Law Judge Decision by the Director of the Office of Administrative Hearings, the effective date of the Order will be five (5) days from the date of that certification.

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-137160-45720000Done this day, September 20, 2021.

/s/ Adam D. Stone

Administrative Law Judge

Transmitted electronically to:

Evan G. Daniels,

Department of Insurance and Financial Institutions - Insurance

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-137160-45720000