Taking the Profit Out of Fraud is Effective

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GEICO Continues to Sue Allegedly Fraudulent Health Care Providers

Defendants Todd Koppel, M.D. and Garden State Pain Management, P.A. (collectively, the “Koppel Defendants”) moved the USDC to quash a subpoena served by Plaintiffs Government Employees Insurance Co., upon the New Jersey Office of the Insurance Fraud Prosecutor (“OIFP”).

In In Re Government Employees Insurance Co., et al. v. Todd Koppel, et al., No. 2:21-cv-03413-MEF-JRA, United States District Court, D. New Jersey (August 28, 2023) the USDC dealt with the right to subpoena the prosecutor’s files.

BACKGROUND

Plaintiffs sued the Koppel Defendants alleging that they unlawfully obtained personal injury protection (“PIP”) benefits from Plaintiffs by making false representations as to their compliance with New Jersey law when, in fact, they were operating in violation of New Jersey law by paying kickbacks to chiropractors in exchange for patient referrals. Plaintiffs asserted claims against the Koppel Defendants pursuant to the New Jersey Insurance Fraud Prevention Act, the civil Racketeer Influenced and Corrupt Organizations, and common law fraud and unjust enrichment.

The Subpoena sought a copy of all criminal and investigative records from the OIFP’s Medicaid Fraud Control Unit concerning the Koppel Defendants.

DISCUSSION

Defendants challenge the Subpoena based on relevancy, privilege, and undue burden. The Court noted that the information Plaintiffs seek overlaps with the allegations in the complaint and is, therefore, relevant.

State statutes provide information in the possession of OIFP can be referred to entities on pending cases of suspected insurance fraud. The Koppel Defendants Motion to quash was, as a result, denied.

The Koppel Defendants also failed to meet their burden to show that good cause existed to issue a protective order.

ZALMA OPINION

GEICO should be honored for its proactive acts against insurance fraud by taking the profit out of insurance fraud since very few such fraudsters are arrested, tried or convicted. Although the OIFP did not prosecute the Koppel Defendants, they collected information that will assist GEICO in its efforts to obtain damages and fines from the Koppel Defendants. Taking the profit out of fraud is more effective than prosecution of fraudsters for crime.

(c) 2023 Barry Zalma & ClaimSchool, Inc.

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