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California Insurance Code Section 1871.4

Legal Research Home > California Laws > Insurance Code > California Insurance Code Section 1871.4

1871.4.  (a) It is unlawful to do any of the following:
   (1) Make or cause to be made a knowingly false or fraudulent
material statement or material representation for the purpose of
obtaining or denying any compensation, as defined in Section 3207 of
the Labor Code.
   (2) Present or cause to be presented a knowingly false or
fraudulent written or oral material statement in support of, or in
opposition to, a claim for compensation for the purpose of obtaining
or denying any compensation, as defined in Section 3207 of the Labor
Code.
   (3) Knowingly assist, abet, conspire with, or solicit a person in
an unlawful act under this section.
   (4) Make or cause to be made a knowingly false or fraudulent
statement with regard to entitlement to benefits with the intent to
discourage an injured worker from claiming benefits or pursuing a
claim.
   For the purposes of this subdivision, "statement" includes, but is
not limited to, a notice, proof of injury, bill for services,
payment for services, hospital or doctor records, X-ray, test
results, medical-legal expense as defined in Section 4620 of the
Labor Code, other evidence of loss, injury, or expense, or payment.
   (5) Make or cause to be made a knowingly false or fraudulent
material statement or material representation for the purpose of
obtaining or denying any of the benefits or reimbursement provided in
the Return-to-Work Program established under Section 139.48 of the
Labor Code.
   (6) Make or cause to be made a knowingly false or fraudulent
material statement or material representation for the purpose of
discouraging an employer from claiming any of the benefits or
reimbursement provided in the Return-to-Work Program established
under Section 139.48 of the Labor Code.
   (b) Every person who violates subdivision (a) shall be punished by
imprisonment in a county jail for one year, or pursuant to
subdivision (h) of Section 1170 of the Penal Code, for two, three, or
five years, or by a fine not exceeding one hundred fifty thousand
dollars ($150,000) or double the value of the fraud, whichever is
greater, or by both that imprisonment and fine. Restitution shall be
ordered, including restitution for any medical evaluation or
treatment services obtained or provided. The court shall determine
the amount of restitution and the person or persons to whom the
restitution shall be paid. A person convicted under this section may
be charged the costs of investigation at the discretion of the court.
   (c) A person who violates subdivision (a) and who has a prior
felony conviction of that subdivision, of former Section 556, of
former Section 1871.1, or of Section 548 or 550 of the Penal Code,
shall receive a two-year enhancement for each prior conviction in
addition to the sentence provided in subdivision (b).
   The existence of any fact that would subject a person to a penalty
enhancement shall be alleged in the information or indictment and
either admitted by the defendant in open court, or found to be true
by the jury trying the issue of guilt or by the court where guilt is
established by plea of guilty or nolo contendere or by trial by the
court sitting without a jury.
   (d) This section may not be construed to preclude the
applicability of any other provision of criminal law that applies or
may apply to a transaction.

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Last modified: March 17, 2014