For Glecina Bethea-Tumani, a misdemeanor conviction for insurance fraud properly prevented her from obtaining a license as a registered nurse even though she had turned her life around, stopped criminal activity, and improved her education sufficiently to qualify as a Registered Nurse. Thus, her case is an example that such a conviction can cause difficulties well after the punishment is fulfilled and the insurance fraud criminal becomes an honest person.

In Pennsylvania, the Commonwealth Court found that it was proper to reject petitioner, Glecina Bethea-Tumani's, petition for a nursing license in Bethea-Tumani v. Bureau of Professional and Occupational Affairs, State Board of Nursing, No. 1547 C.D. 2009 (Pa. Commw. 04/28/2010), because she had previously been convicted of insurance fraud.

Glecina Bethea-Tumani petitioned the court to review a final adjudication and order of the State Board of Nursing (Board), denying her application for a license as a registered nurse by examination under the Professional Nursing Law (Law). In April 1994, Applicant pled guilty to aggravated assault, a felony. In July 2008, she pled guilty to insurance fraud and conspiracy, two misdemeanors. She applied to the Board for a license on or about September 8, 2008. In its final adjudication and order, the Board denied Applicant's license application based on these convictions.

Glecina was 19 years old when, on or about February 4, 1994, she was involved in a fight with another female after leaving work. The verbal altercation, which the other female appears to have initiated, grew into a physical one. Glecina claimed that during the fight she saw something that looked like a knife in the other female's hand. Part of Glecina's work uniform included an apron with a box cutter in the front pocket. She pulled the box cutter out of her apron pocket and cut the other female's arm. Bystanders broke up the fight, and the women went their separate ways. A few days later, detectives arrested Glecina who subsequently pled guilty to aggravated assault and served six months in Philadelphia County Prison.

In July 2008 Glecina pleaded guilty to insurance fraud and conspiracy that arose out of a September 2004 incident. While driving her vehicle, she sideswiped a pole. Glecina took the car to an auto body shop for a repair estimate. She and the auto body manager reviewed the damages to the vehicle. When the manager excused himself to take a call, a man, identifying himself as a police officer, approached Glecina. The man told her that he could help her by writing a report of the accident that made it appear that the accident was not her fault and that he would cover the $500 deductible. When she asked how he would do that, the man told her not to worry, it would be fine, and that he would take care of everything. She acquiesced after he showed her a badge, believing the man would not steer her wrong.

In 2007, a Federal Bureau of Investigation agent and a Philadelphia police officer questioned Glecina and informed her that she was going to be arrested as part of an insurance scam that involved over 300 people. She pled guilty to insurance fraud and conspiracy, two misdemeanors. The court sentenced her to two years supervised probation and ordered her to pay costs and fees of $183.00 and restitution of $3,000.00.

Glecina contended that the Board failed to issue a reasoned decision. The court found that although case law in the state indicates that there is a need for a decision that sets forth reasons and is sufficient to allow for meaningful appellate review, it does not establish a per se requirement that all agency decisions involving conflicting evidence where the fact-finder does not observe the witness' demeanor must provide the same level of detail for the rejection of testimony as a WCJ must provide pursuant to Section 422(a) of the Act. That is not to say, however, that there must not be some objective basis for the decision.

This case actually does not involve conflicting evidence. Rather, the evidence consisted of the documents considered by the Board-i.e., materials related to Glecina's application and convictions, and Applicant's testimony, which was consistent with those materials.

The court agreed with Glecina that the Board could have issued an opinion with more detailed factual findings regarding her asserted remorsefulness and personal accomplishments,the court could not conclude that the Board's findings and conclusions are so lacking as to not meet the minimal requirements for an adjudication.

Given the circumstances of this case, in particular the very recent conviction, the court could not conclude that the Board erred in considering the earlier conviction. Moreover, the court noted that even if the Board had erred in considering the earlier conviction, sufficient evidence exists to support the Board's denial based solely on the recent insurance fraud and conspiracy conviction. Under the statutes the Board is authorized to refuse to issue a license to an applicant where the applicant has pled guilty to a felony or crime of moral turpitude, and it is undisputed that Glecina committed such crimes.

Barry Zalma, Esq., CFE, is an insurance fraud expert and expert witness.  He is the author and publisher of ZIFL, Zalma's Insurance Fraud Letter, which is available at www.zalma.com.  Zalma's office phone number is 310 390-4455.