Administrative Actions July 2021

​Last Updated: August 2, 2021

For more information contact: Richard Wicka, Chief Legal Counsel
(608) 261-6018 or richard.wicka@wisconsin.gov


Madison, Wis. — ​The Office of the Commissioner of Insurance (OCI) is responsible for administering and enforcing the insurance laws of Wisconsin. This includes monitoring the financial and marketing practices of individuals and companies. Each month, OCI publishes the administrative actions it has taken against these entities. The actions are issued by OCI when licensing applicants, or licensed individuals or companies have violated Wisconsin insurance statutes or regulations. In some cases, the individual or company denied the stated allegations but consented to the action taken. OCI strives to ensure fair and honest business practices to protect Wisconsin insurance consumers through this type of transparency. Copies of the administrative orders may be viewed online at ociaccess.oci.wi.gov/OrderInfo/OrdInfo.oci.

Any forfeitures paid are deposited in Wisconsin's Common School Fund administered by the Board of Commissioners of Public Lands. Earnings from the Fund are distributed to all public K-12 schools in the state and are used by school libraries to purchase materials such as books, newspapers, and computers.

If you have a question or complaint regarding an insurance company or agent you can use the online complaint form on our website, oci.wi.gov, or contact OCI at 1-800-236-8517.

Allegations and Actions Against Agents

Jumuel A. Cannon, 4626 W. Deer Run Dr., Apt. 204, Brown Deer, WI 53223, had her insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Stanford L. Clacks, Jr., 5132 Brandenburg Way, Madison, WI 53718, had his application for an insurance license denied for 90 days. This action was taken based on allegations of failing to disclose administrative actions taken by the states of Indiana and Wisconsin on a licensing application and failing to timely disclose an administrative action taken by the State of Indiana while actively licensed in Wisconsin.

Heather L. Cruver, 1523 Lincoln Ave., Plattsmouth, NE 68048, had her insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Dynah R. Edang, 3772 E Pulaski Ave., Cudahy, WI 53110, had her application for an insurance license denied for 60 days. This action was taken based on allegations of failing to disclose an administrative action taken by the State of Wisconsin on a licensing application.

Nicole R. Etter, 4119 N Woodburn St., Shorewood, WI 53211, had her application for an insurance license denied for 31 days. This action was taken based on allegations of failing to disclose administrative actions taken by the states of Washington and Wisconsin on a licensing application, and failing to fully complete an application form.

Thomas Giebel, 3678A E Birchwood Ave., Cudahy, WI 53110, had his insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Beth Gifford, 3171 Dayton St., Magna, UT 84044, was ordered to pay a forfeiture of $500.00. This action was taken based on allegations of failing to timely disclose to OCI administrative actions taken by the states of South Dakota, Louisiana, and California.

Beth Gifford, 3171 Dayton St., Magna, UT 84044, had her insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Piroshka Gowdy, 1342 S Glen Cir., Apt. C, Aurora, IL 60506, had her insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Paul Haan, 3969 Bayshore Dr., Sturgeon Bay, WI 54235, was ordered to pay a forfeiture of $500.00. This action was taken based on allegations of failing to timely disclose to OCI administrative actions taken by the states of South Dakota, Kansas, and Indiana.

Paul Haan, 3969 Bayshore Dr., Sturgeon Bay, WI 54235, had his insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Phillip E. Ipsan, 1040 Bayview Dr., Ste. 610, Fort Lauderdale, FL 33304, had his insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Francis Jablonski, 115 Washington St., Fountain City, WI 54629, had his application for an insurance license denied for 31 days. This action was taken based on allegations of having a criminal conviction that may be substantially related to insurance marketing type conduct.

Jaimie A. Jackson, 13601 S 44th St., Apt. 3035, Phoenix, AZ 85044, had her insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Jose D. Jaramillo Arvizu, 2101 N Evergreen St., Apt. 10445, Chandler, AZ 85225, had his insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Jose D. Jaramillo Arvizu, 2290 E Yeager Dr., Chandler, AZ 85286, was ordered to pay a forfeiture of $500.00. This action was taken based on allegations of failing to timely disclose to OCI administrative actions taken by the states of Louisiana, Indiana, North Carolina, and California.

Jeremiah R. Johnson, 3019 N 47th St., Milwaukee, WI 53210, had his insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Cokilya Keith, 420 Pilot Rd., Las Vegas, NV 89119, was ordered to pay a forfeiture of $500.00. This action was taken based on allegations of failing to timely disclose to OCI administrative actions taken by the states of Virginia, Washington, and Louisiana.

Cokilya Keith, 807 1/2 S 3rd St., Las Vegas, NV 89101, had his insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Taimur Khan, 102 N Water St., Unit 401, Milwaukee, WI 53202, agreed to the issuance of a conditional license having a 30-day denial period and certain disclosure requirements. This action was taken based on allegations of having criminal convictions that may be substantially related to insurance marketing type conduct, failing to fully disclose the convictions on a licensing application, and failing to provide information requested by OCI.

Kristine L. Larson, 319 N Madison St., Waupun, WI 53963, had her insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Theresa M. Lasee, 2757 Moose Creek Trl., Green Bay, WI 54313, had her insurance license summarily suspended. This action was taken based on allegations of committing financial fraud.

Kabir Leon, 300 Forest Center Dr., Apt. 31102, Kingwood, TX 77339, had his insurance license revoked. This action was taken based on allegations of failing to pay a non-resident licensing fee.

Darlene M. Mosbaugh, 75443 Schmenski Rd., Glidden, WI 54527, had her insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Sean P. O'Connor, 519 N 93rd St., Milwaukee, WI 53226, had his insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Jonathan I. Oner, 817 15th Ave., Unit 210, Monroe, WI 53566, had his application for an insurance license denied. This action was taken based on allegations of having criminal convictions that may be substantially related to insurance marketing type conduct and failing to provide documentation required to complete a licensing application.

Eric Oster, Jr., 1946 Fittin Ct., Lantana, FL 33461, had his insurance license revoked. This action was taken based on allegations of failing to pay a non-resident licensing fee.

Jason W. Perez, 13328 W Stella Ln., Litchfield Park, AZ 85340, was ordered to pay a forfeiture of $500.00. This action was taken based on allegations of failing to timely disclose to OCI administrative actions taken by the states of Florida, Indiana, and California.

Jason W. Perez, 13328 W Stella Ln., Litchfield Park, AZ 85340, had his insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Jose I. Perez-Hernandez, 2615 N. Cramer St., Apt. 36, Milwaukee, WI 53211, had his insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Carla J. Petersen, 615 Stow St., Fond du Lac, WI 54935, had her insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Rolando A. Rodriguez, 5255 S 22nd St., Milwaukee, WI 53221, had his application for an insurance license denied for 60 days. This action was taken based on allegations of failing to disclose administrative actions taken by the states of California and Wisconsin on a licensing application and failing to timely provide documentation required to complete a licensing application.

Chad M. Schampers, 2004 Ledgeview Rd., De Pere, WI 54115, had his application for an insurance license denied. This action was taken based on allegations of having criminal convictions that may be substantially related to insurance marketing type conduct; being named in lawsuits containing allegations of fraud, misrepresentation, misappropriation, or breach of fiduciary duty; demonstrating financial irresponsibility in the conduct of business; providing false and incomplete information on a licensing application; and failing to apply for and obtain a federal crime waiver.

Theron "Terry" G. Seitz, 1865 Arrowhead Dr., Beloit, WI 53511, had his insurance license revoked. This action was taken based on allegations of owing delinquent Wisconsin taxes.

Lewis Shaver, 6663 Seaway Dr., Brooksville, FL 34604, was ordered to pay a forfeiture of $4,000.00. This action was taken based on allegations of failing to timely disclose to OCI administrative actions taken by the states of Kentucky, Utah, Indiana, Nebraska, Illinois, Louisiana, Virginia, and Maryland.

Lewis Shaver, 6663 Seaway Dr., Brooksville, FL 34604, had his insurance license revoked. This action was taken based on allegations of failing to timely pay an ordered forfeiture.

Adam Sokeland, 2888 Joellen Ln., Apt. 2C, Newburgh, IN 47630, had his application for an insurance license denied. This action was taken based on allegations of owing delinquent child support.

Richard J. Wilkinson, 5215 W Wiley Post Way, Ste. 200, Salt Lake City, UT 84116, was ordered to pay a forfeiture of $500.00 and was ordered to provide all information requested by OCI regarding a consumer complaint, and to timely and fully respond to all inquiries from OCI. These actions were taken based on allegations of failing to timely respond to inquiries from OCI.

Andrew Williams, 4509 N 108th St., Wauwatosa, WI 53225, had his application for additional insurance authority denied. This action was taken based on allegations of failing to timely respond to inquiries from OCI, failing to disclose an employment termination for cause on a licensing application, and falsifying information on insurance applications.

Andrew Williams, 4509 N 108th St., Wauwatosa, WI 53225, had his application for additional insurance authority denied. This action was taken based on allegations of failing to disclose an administrative action taken by the State of Wisconsin on a licensing application; having an insurance company appointment termination for cause; failing to respond promptly to OCI requests for information; and providing false information on a previous licensing application.

Allegations and Actions Against Companies

Colonial Surety Company, 123 Tice Blvd., Ste. 250, Woodcliff Lake, NJ 07677, was ordered to pay a forfeiture of $500.00. This action was taken based on allegations of failing to timely file a required form with OCI.

SimplyIOA, LLC, 1855 W State Rd., Ste. 434, Longwood, FL 32750, had its application for an insurance license denied. This action was taken based on its history of administrative actions.