Insurance agents in Texas go through a good amount of training and jump through a number of hoops in order to become licensed by the Texas Department of Insurance. This is why it can be so distressing for them to receive notice that they are the subject of a complaint investigation. Such an investigation is a threat to the agent’s ability both to practice their chosen profession and to enjoy their livelihood. After all, the Department is endowed with the capacity to impose a variety of sanctions on the license of an agent. It can impose limits on an agent’s license, it can put an agent’s license under suspension, and, at worst, it can fully revoke the license of an agent to be employed in the insurance industry.
The Department imposes its discipline for many reasons. Among the more common of these reasons—as codified in section 4005.101 of the Texas Insurance Code—are:
(1) has wilfully violated an insurance law of this state;
(2) has intentionally made a material misstatement in the license application;
(3) has obtained or attempted to obtain a license by fraud or misrepresentation;
(4) has misappropriated, converted to the applicant's or license holder's own use, or illegally withheld money belonging to:
(A) an insurer;
(B) a health maintenance organization; or
(C) an insured, enrollee, or beneficiary;
(5) has engaged in fraudulent or dishonest acts or practices;
(6) has materially misrepresented the terms and conditions of an insurance policy or contract, including a contract relating to membership in a health maintenance organization;
(7) has made or issued, or caused to be made or issued, a statement misrepresenting or making incomplete comparisons regarding the terms or conditions of an insurance or annuity contract legally issued by an insurer or a membership issued by a health maintenance organization to induce the owner of the contract or membership to forfeit or surrender the contract or membership or allow it to lapse for the purpose of replacing the contract or membership with another;
(8) has been convicted of a felony;
(9) has offered or given a rebate of an insurance premium or commission to an insured or enrollee;
(10) is not actively engaged in soliciting or writing insurance for the public generally as required by Section 4001.104(a) ; or
(11) has obtained or attempted to obtain a license, not for the purpose of holding the applicant or license holder out to the general public as an agent, but primarily for the purpose of soliciting, negotiating, or procuring an insurance or annuity contract or membership covering:
(A) the applicant or license holder;
(B) a member of the applicant's or license holder's family; or
(C) a business associate of the applicant or license holder.
And they should do so, given all they’ve been through. This is no time to lie down and take it: this is the time to fight.
Contact an experienced insurance license defense attorney for legal help
As soon as you learn your license to practice in the insurance industry has been threatened, you should contact a professional license attorney. BERTOLINO LLP can help. We are experienced license defense attorneys and we know how to navigate the appeals process before the Texas Department of Insurance. We are skilled at assisting professionals in determining the course of action that will be beneficial or detrimental to their career depending on the particular situation. Immediately consulting an experienced license defense attorney to review the risk to your license helps ensure the most favorable outcome in your case.
With offices in Austin, Houston, and San Antonio, we serve medical professional clients all over the state. Contact us today or call (512) 717-5432 and schedule a case evaluation.