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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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July 14, 2022
Guilty of Using Stolen Prescription Pad to Obtain Oxycodone

Drug Dealer Chiropractor Not Allowed into Pretrial Intervention Program

Read the full article at https://lnkd.in/gu2igmKA and see the full video at https://lnkd.in/gieZ_syz and at https://lnkd.in/gSXWSeSE and at https://zalma.com/blog plus more than 4250 posts.
Posted on July 14, 2022 by Barry Zalma

See the full video at https://rumble.com/v1c0dxh-guilty-of-using-stolen-prescription-pad-to-obtain-oxycodone.html?mref=6zof&mrefc=2 and at

The New Jersey Pretrial Intervention Program (PTI) “is a diversionary program through which certain offenders are able to avoid criminal prosecution by receiving early rehabilitative services expected to deter future criminal behavior.” State v. Oguta, 468 N.J.Super. 100, 107 (App. Div. 2021) (quoting State v. Nwobu, 139 N.J. 236, 240 (1995)). Jason Mittleman appealed from an order denying his motion to compel his admission into the PTI program.

In State Of New Jersey v. Jason Mittleman, No. A-0925-20, Superior Court of New Jersey, Appellate Division (June 22, 2022) the Chiropractor appealed the refusal to allow him in the PTI program.
FACTS

Mittleman is a chiropractor. In 2017, he was working at the Denville Medical and Sports Rehabilitation Center where he stole another doctor’s prescription pad. Over the next twenty-two months, Mittleman submitted false prescriptions to obtain thousands of oxycodone pills.

Mittleman’s theft and fraud came to light in 2019. During the ensuing police investigation, Mittleman admitted he stole the prescription pad, fraudulently filled out numerous prescriptions, and used those prescriptions to obtain oxycodone.

Mittleman was indicted for third-degree obtaining oxycodone by fraud; third-degree insurance fraud; third-degree receiving stolen property; and fourth-degree tampering with or fabricating physical evidence.
The PTI Program

Mittleman applied for admission into the PTI program. The Morris County Prosecutor’s Office rejected his application and set forth the reasons for that decision. An assistant prosecutor reviewed the seventeen factors set forth in the PTI statute and found ten aggravating factors, considered several mitigating factors, but determined that Mittleman was not a suitable candidate for the PTI program.

A Law Division judge heard arguments on Mittleman’s motion motion, denied the motion, and set forth the reason for that decision on the record. That same day, the Law Division judge entered an order denying Mittleman’s motion to compel his entry into the PTI program.
Guilty Plea

The following month, Mittleman pled guilty to third-degree insurance fraud. In accordance with the plea agreement, Mittleman was sentenced to one year probation with a condition that he surrender his chiropractic license during the probationary period. The other charges against Mittleman were dismissed.

Mittleman appealed from the order denying his motion to compel his entry into the PTI program. Mittleman’s arguments were rejected because they were not supported by the record.
DISCUSSION

Prosecutors are granted broad discretion to determine if any defendant, including Mittleman, should be diverted to PTI instead of being prosecuted. The scope of judicial review is severely limited by the statute.

To overturn a prosecutor’s rejection, a defendant must clearly and convincingly establish that the prosecutor’s decision constitutes a patent and gross abuse of discretion. A patent and gross abuse of discretion is a decision that has gone so wide of the mark sought to be accomplished by PTI that fundamental fairness and justice requires judicial intervention.

There is nothing in the record establishing that Mittleman had a lawful prescription for oxycodone. The material fact, which was undisputed, was that Mittleman fraudulently obtained oxycodone.

The prosecutor also considered Mittleman’s use of the oxycodone. In that regard, the prosecutor noted that Mittleman claimed he had ceased using oxycodone voluntarily and, therefore, the State noted that there was no clear demonstration of an addiction that could be better treated through rehabilitative programs like PTI.

There is nothing in the record indicating that the State incorrectly believed that Mittleman provided oxycodone pills to his girlfriend. Instead, the prosecutor in his rejection letter noted that Mittleman admitted to using his former girlfriend’s name on forged prescriptions so that he could obtain more prescriptions for himself. The prosecutor also pointed out that Mittleman admitted that sometimes he distributed the oxycodone pills to other individuals.

Records recovered during the criminal investigation showed that Mittleman received fraudulent prescriptions of oxycodone from April 2017 until February 2019. During that same period, he was treating patients. Accordingly, it is not pure speculation that Mittleman’s unprescribed use of oxycodone could have placed his patients at risk.

The appellate court rejected Mittleman’s arguments concerning factual errors by the prosecutor because those arguments were not supported by the record and affirmed the trial court’s decision.
ZALMA OPINION

For a health care provider to steal a prescription pad and obtain for his personal use and distribution to others oxycodone illegally to seek admission to the PTI program would have allowed him to avoid his admitted criminal conduct. That he appealed the denial after being allowed to plead guilty to only one count and be sentenced only to probation was unconscionable. He should have been sentenced to prison for such egregious conduct and abuse of his profession.
Just published
Random Thoughts on Insurance Volume XIV: A Collection of Blog Posts from Zalma on Insurance —

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at

http://www.zalma.com and [email protected].

Subscribe and receive videos limited to subscribers of Excellence in Claims Handling at locals.com https://zalmaoninsurance.locals.com/subscribe.

Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.

Write to Mr. Zalma at [email protected]; http://www.zalma.com

; http://zalma.com/blog; daily articles are published at https://zalma.substack.com.

Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

00:08:18
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20 hours ago
Allegations That Establish Breach of a Condition Defeats Suit

Notice of Claim Later than 60 Days After Expiration is Too Late

Post 5089

Injury at Massage Causes Suit Against Therapist

Read the full article at https://lnkd.in/gziRzFV8, see the full video at https://lnkd.in/gF4aYrQ2 and at https://lnkd.in/gqShuGs9, and at https://zalma.com/blog plus more than 5050 posts.

Hiscox Insurance Company (“Hiscox”) moved the USDC to Dismiss a suit for failure to state a claim because the insured reported its claim more than 60 days after expiration of the policy.

In Mluxe Williamsburg, LLC v. Hiscox Insurance Company, Inc., et al., No. 4:25-cv-00002, United States District Court, E.D. Missouri, Eastern Division (May 22, 2025) the trial court’s judgment was affirmed.

FACTUAL BACKGROUND

Plaintiff, the operator of a massage spa franchise, entered into a commercial insurance agreement with Hiscox that provided liability insurance coverage from July 25, 2019, to July 25, 2020. On or about June 03, 2019, a customer alleged that one of Plaintiff’s employees engaged in tortious ...

00:08:31
June 02, 2025
Zalma’s Insurance Fraud Letter – June 1, 2025

ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Posted on June 2, 2025 by Barry Zalma

Post 5087

See the full video at and at

Read the full article and the full issue of ZIFL June 1, 2025 at https://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-06-01-2025.pdf

Zalma’s Insurance Fraud Letter – June 1, 2025

See the full video at https://lnkd.in/gw-Hgww9 and at https://lnkd.in/gF8QAq4d, and at https://zalma.com/blog plus more than 5050 posts.

ZIFL – Volume 29, Issue 11

The Source for the Insurance Fraud Professional

Read the full article and the full issue of ZIFL June 1, 2025 at https://lnkd.in/gTWZUnnF

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at ...

00:08:42
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May 30, 2025
Plain Language of Policy Enforced

No Coverage if Home Vacant for More Than 60 Days

Failure to Respond To Counterclaim is an Admission of All Allegations

Post 5085

See the full video at https://lnkd.in/gbWPjHub and at https://lnkd.in/gZ9ztA-P, and at https://zalma.com/blog plus more than 5050 posts.

In Nationwide Mutual Insurance Company v. Rebecca Massey, Civil Action No. 2:25-cv-00124, United States District Court, S.D. West Virginia, Charleston Division (May 22, 2025) Defendant Nationwide Mutual Insurance Company's (“Nationwide”) motion for Default Judgment against Plaintiff Rebecca Massey (“Plaintiff”) for failure to respond to a counterclaim and because the claim was excluded by the policy.

BACKGROUND

On February 26, 2022, Plaintiff's home was destroyed by a fire. At the time of this accident, Plaintiff had a home insurance policy with Nationwide. Plaintiff reported the fire loss to Nationwide, which refused to pay for the damages under the policy because the home had been vacant for more than 60 days.

Plaintiff filed suit ...

00:06:50
May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:

Health Care Fraud Trial Results in Murder for Hire of Witness

To Avoid Conviction for Insurance Fraud Defendants Murder Witness

In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.

In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:

Insurance Coverage Dispute:

Travelers issued a Commercial General Liability ...

April 30, 2025
The Devil’s in The Details

A Heads I Win, Tails You Lose Story
Post 5062

Posted on April 30, 2025 by Barry Zalma

"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators than any Other Crime."

Immigrant Criminals Attempt to Profit From Insurance Fraud

People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.

The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...

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