Marlene Caride, Etc. v. Paul B. Kumar

New Jersey Superior Court Appellate Division·Decided December 29, 2023·No. A-2627-21·Unpublished

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION

DOCKET NO. A-2627-21

MARLENE CARIDE, COMMISSIONER, NEW JERSEY DEPARTMENT OF BANKING AND INSURANCE,

Petitioner-Respondent,

v. PAUL B. KUMAR,

Respondent-Appellant.

Argued October 31, 2023 – Decided December 29, 2023 Before Judges Whipple, Mayer and Paganelli.

On appeal from the New Jersey Department of Banking and Insurance, Docket No. OTSC #E18-54.

Michael James Confusione argued the cause for appellant (Hegge and Confusione, LLC, attorneys;

Michael James Confusione, of counsel and on the briefs).

Richard E. Wegryn, Jr., Deputy Attorney General, argued the cause for respondent (Matthew J. Platkin, Attorney General, attorneys; Donna Sue Arons,

Assistant Attorney General, of counsel; Telge Nadeesha Peiris, Deputy Attorney General, on the brief).

PER CURIAM Appellant Paul B. Kumar appeals from a final agency decision of Commissioner of the Department of Banking and Insurance (Commissioner or Department), revoking his insurance producer license and imposing $60,774.25 in civil penalties, surcharge, attorney's fees and costs of investigation, for violations of the New Jersey Insurance Producer Licensing Act of 2001 (Producer Act), N.J.S.A. 17:22A-26 to -48; N.J.A.C. 11:17A-4.2; and the New Jersey Insurance Fraud Prevention Act (Fraud Act), N.J.S.A. 17:33A-1 to -30. We affirm.

I.

We derive the facts from the record developed at the hearing conducted in the Office of Administrative Law (OAL). Since October 1, 2008, Kumar was a licensed insurance producer in the State of New Jersey.

"On August 3, 2015, Kumar entered into an employment contract with Combined Insurance Company (Combined)." For any insurance policy to be written, Combined requires: the producer to meet, face to face, with the insurance applicant; the applicant to sign the application; and the producer to

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witness the applicant's signature on the application. These requirements were never waived and applied to Kumar.

Combined provided Kumar with a lead sheet for an existing customer, Joseph Hunsicker. The lead sheet "listed Joseph's address as 124 W. Farrell Ave, Apt. A2, Trenton, New Jersey . . . ." On September 23, 2015, Kumar and Joseph met at Joseph's home in Ewing, New Jersey. Kumar submitted insurance applications to Combined on Joseph's behalf. Joseph referred Kumar to family members, including: Ronald Hunsicker, his brother; Kathleen Seibert, Ronald's wife; Robin Hunsicker, Ronald's daughter; and Robert Hunsicker, Ronald's son.1 On November 7, 2015, Kumar submitted an insurance application to Combined on behalf of Ronald. However, Ronald had advised Kumar that he did not need insurance because "he had coverage from his employer." Moreover, Ronald "never met Kumar, never applied for insurance with Combined and never signed the applications in Kumar's presence." Indeed, on the day Kumar submitted Ronald's application, Ronald and Kathleen were "enroute to a vacation in Mexico." Further, this application contained the "incorrect spelling of [Kathleen]'s first name, her incorrect legal last name and

1 Since there are a number of individuals with the last name Hunsicker we refer to them by their first name. We intend no disrespect.

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her incorrect birthdate." Moreover, the insurance application erroneously listed his address as Joseph's from the lead sheet even though Ronald resided in Delaware.

"On December 9, 2015, Kumar submitted a second insurance application to Combined for Ronald." Again, the insurance application listed his wrong address and contained Ronald's incorrect height and weight.

Also on December 9, Kumar submitted an insurance application to Combined on behalf of Kathleen. However, Kathleen "never met Kumar, never applied for insurance with Combined, and never signed any applications for insurance in the presence of Kumar." The insurance application "erroneously listed her address [as Joseph's from the lead sheet] even though [Kathleen] resided in Delaware"; "incorrectly listed [Kathleen]'s height, weight, and the existence of prior life insurance."

Kumar submitted an insurance application to Combined on behalf of Robin on November 7, 2015, and two more on December 16, 2015. However, "Robin never met Kumar, never applied for insurance with Combined, and never signed any applications for insurance in the presence of Kumar." The November 7 application listed Robin's wrong date of birth; the first December 16 application listed her wrong "middle initial, birthdate, height and weight and

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that she did not have insurance"; and the second December 16 application listed the wrong "middle initial, birthdate, occupation, employer, height and weight, income and physician." When Robin discovered the insurance applications were submitted, she sent "a letter to Combined requesting [for] Combined to cancel the policy."

"On November 2, 2015, Kumar submitted two insurance applications to Combined for Robert." While Robert provided Kumar with "his name, address and date of birth . . . he never applied for a policy, never met Kumar, and never signed the two applications submitted by Kumar under his name."

Dana Camadine (Camadine), Combined's manager of its compliance department, "became aware of the applications upon her review of the weekly compensation report." The applications were listed on the report because they were above a designated dollar threshold. She initiated an investigation. Ultimately, she "prepared an investigative report which concluded that Kumar violated company policy by submitting fraudulent applications to the company." Kumar "was terminated for violation of Combine[d]'s zero tolerance policy." "When Kumar was terminated, a referral was made to the State for insurance fraud . . . ."

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On May 28, 2018, the Department issued a two-count Order to Show Cause (OTSC) to Kumar concerning the insurance applications. In the first count, the Department alleged violations of the Producer's Act, N.J.S.A. 17:22A-40a(2), (5), (7), (8), (10), and (16); and N.J.A.C. 11:17A-4.2 because Kumar did not "witness the signature[s] of prospective insured[s]; did not have . . . face to face meeting[s] with the prospective insured[s] with regard to the application prior to submitting it, and forged the prospective insureds' signatures on the applications."

In the second count, the Department alleged violations of the Fraud Act, N.J.S.A. 17:33A-4a(3) and 4a(4)(b), because Kumar "submitted . . . insurance policy applications to Combined . . . for the purpose of obtaining an insurance policy, knowing that each of these applications contained a forged signature of the prospective insured, and other false or misleading information concerning any fact or thing material to the application or contract . . . . "

The Department demanded that Kumar show cause why: his New Jersey insurance producer license should not be suspended or revoked pursuant to N.J.S.A. 17:22A-40a; civil penalties should not be assessed under the Fraud Act, N.J.S.A. 17:33A-5(c) and N.J.A.C. 11:16-7.9(a); a surcharge should not be imposed under N.J.S.A. 17:33A-5.1; civil penalties should not be assessed under

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N.J.S.A. 17:22A-45(c); costs of the investigation and prosecution, including attorney's fees, should not be reimbursed pursuant to N.J.S.A. 17:22A-45(c), N.J.S.A. 17:33A-5(c) and N.J.A.C. 11:16-7.9(a).

Kumar disputed the charges, and the Department transmitted the matter to the OAL for hearing as a contested case. The ALJ held hearings on August 12, 13, 19, and September 3, 2020. At the conclusion of the hearings, the ALJ issued a thorough fifty-three-page decision.

The ALJ made detailed findings regarding the witnesses' credibility.

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