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Maine Bureau of Insurance
Docket No. INS 04-420

TO: Wendy C. Lainez

Re: Misleading representations

Dear Ms. Lainez:

Please accept this as a formal Letter of Reprimand from the Superintendent of the Maine Bureau of Insurance (“the Superintendent”). The purpose of the letter is to address your misleading representations while soliciting insurance to Henry and Mary Brown.

FACTS

1. Wendy C. Lainez is licensed by the Superintendent as a resident insurance producer, License No. PRR84974. Her National Producer Identification number is 7136444.

2. Ms. Lainez is and was at all times relevant to this matter an appointed insurance producer for Bankers Life and Casualty Company, Maine License No. LHF127, based at its branch sales office in Bangor, Maine.

3. On October 27, 2003, Ms. Lainez contacted Henry and Mary Brown of Bar Harbor, Maine by telephone and arranged to meet with them to discuss their eligibility for certain prescription drug benefits from the State of Maine.

4. Ms. Lainez did not tell the Browns that the purpose of this meeting was for her to solicit insurance products to the Browns.

5. Although Ms. Lainez indicated in her telephone conversation that she worked for “Bankers Life,” she did not tell the Browns that Bankers Life was an insurance company or that she was an insurance producer.

6. On October 29, Ms. Lainez went to the Browns’ residence and presented them with her business card.

7. Ms. Lainez’s business card identified her as “A Retirement Planner” from Bankers Life and Casualty Company. Nowhere on the card did the words “insurance,” “agent,” or “producer” appear.

8. Ms. Lainez initially discussed State prescription benefits with the Browns.

9. The Browns did not realize that Ms. Lainez was an insurance agent until sometime later when she brought up the subject of Medicare and Medicare supplement insurance.

10. At this point, the Browns told Ms. Lainez that they had Medicare supplement insurance from Conseco.

11. Ms. Lainez then told the Browns that “Conseco” was bankrupt.

12. In fact, Conseco Health Insurance Company, which was the insurance company that issued the Medicare supplement policies to the Browns, was not bankrupt, insolvent, or engaged in any bankruptcy proceedings.

13. Ms. Lainez did not tell the Browns that she was referring to Conseco, Inc., which is not an insurance company, but a holding company that owns several insurance companies.

14. Ms. Lainez did not tell the Browns that Conseco Health Insurance Company was not bankrupt.

15. Ms. Lainez did not tell the Browns that Bankers Life and Casualty Company, like Conseco Health Insurance Company, is a wholly owned subsidiary of Conseco, Inc.

BUREAU FINDINGS

16. Even though she may not have intended to mislead the Browns, Ms. Lainez’s statement that “Conseco” was bankrupt was a false statement and a misleading representation as to the financial condition of Conseco Health Insurance Company made in the course of soliciting Medicare supplement insurance and, as such, constitutes a violation of 24-A M.R.S.A. §§ 2153 and 2157 and Bureau of Insurance Rule Chapter 275 §§ 20(B)(1) and (2).

17. Under the above facts and circumstances, Ms. Lainez’s use of a business card that identified her as “A Retirement Planner” without identifying her as an insurance agent for an insurance company was a statement with respect to a person in the business of insurance that was deceptive and misleading and constitutes a violation of 24-A M.R.S.A. § 2154.

18. Even though she may have simply been following standard practices of Bankers Life, Ms. Lainez’s actions to set up an appointment to meet with the Browns and to enter their home without identifying herself as an insurance producer was a method of marketing that failed to disclose in a conspicuous manner that her purpose was the solicitation of insurance and constitutes a violation of Bureau of Insurance Rule Chapter 275 § 20(B)(3).

RIGHT TO APPEAL

19. The Superintendent is the official charged with administering and enforcing Maine’s insurance laws and regulations. Title 24-A M.R.S.A. § 12-A(3) provides that the Superintendent may issue a Letter of Reprimand to any licensee after providing an opportunity for a hearing. In accordance with 24-A M.R.S.A. § 229(3), you have thirty (30) days from the time you receive this Letter of Reprimand to request a hearing. If a hearing is requested, the effective date of this Letter of Reprimand will be suspended pending the hearing. This Letter of Reprimand is a public record within the meaning of 1 M.R.S.A. § 408. It will be reported to the NAIC and included in the RIRS database.

Nothing herein shall prohibit the Superintendent from seeking additional sanctions in the event that additional violations are brought to the attention of the Bureau.

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