(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.
Notes of Decisions
Minor v. Fedex Off. & Print Servs., Inc., 182 F. Supp. 3d 966 (N.D. Cal. 2016).
· cites it 7× “Specifically, Plaintiff appears to assert a workers’ compensation insurance fraud claim under California Insurance Code § 1871.4. ECF No.”
People v. Hamilton, 30 Cal. App. 5th 673 (Cal. Ct. App. 2018).
· cites it 4× “The Convictions Are Not Supported by Substantial Evidence We next discuss Hamilton's challenge to the sufficiency of the evidence to support each of his three convictions for violating Insurance Code section 1871.4, subdivision (a)(1), which the People concede has merit.”
People v. O'Casey, 88 Cal. App. 4th 967 (Cal. Ct. App. 2001).
· cites it 4× “Appellant Scarlett O’Casey was charged by amended information filed April 6, 1999, with four felony counts: making a knowingly false material statement for the purpose of obtaining workers’ compensation benefits as defined in Labor Code section 3207 (Ins. Code, § 1871.4, subd.…”
People v. Dieguez, 89 Cal. App. 4th 266 (Cal. Ct. App. 2001).
“1 Insurance Code section 1871.4 will be referred to as section 1871.”
People ex rel. Alzayat v. Hebb, 18 Cal. App. 5th 801 (Cal. Ct. App. 2017).
“( Ins. Code, § 1871.4, subd. (b).) In addition, the IFPA provides for civil liability for various forms of workers' compensation insurance fraud.”
People v. Pierce, 38 Cal. App. 5th 321 (Cal. Ct. App. 2019).
· cites it 3× “(a)(1), (2), (5), (7), (8) ; Ins. Code, § 1871.4, subd. (a)(2) ) 2 ; 127 overt acts were alleged.”
People v. Webb, 74 Cal. App. 4th 688 (Cal. Ct. App. 1999).
· cites it 2× “The baskets of fish he is shown lifting on the videotape weighed less than 20 pounds. False Statements Theft by false pretenses, and the violation of Insurance Code section 1871.”
People v. Post, 94 Cal. App. 4th 467 (Cal. Ct. App. 2001).
· cites it 2× “Defendant, Setsuko Betty Post, appeals from her convictions for one count of workers’ compensation insurance fraud (Ins. Code, § 1871.4, subd. (a)(1)) and two counts of perjury.”
Farmer Bros. Coffee v. Workers' Comp. Appeals Bd., 133 Cal. App. 4th 533 (Cal. Ct. App. 2005).
“Insurance Code Section 1871.4 Petitioner contends that Ruiz’s use of a fraudulent Social Security card and fraudulent green card to obtain employment, and then putting a false Social Security number on his workers’ compensation claim form, violated Insurance Code, section 1871.”
Pac. Gas & Elec. Co. v. Superior Court, 144 Cal. App. 4th 19 (Cal. Ct. App. 2006).
“7(c), where there is a reasonable basis, supported by specific information available for review by the California Department of Insurance, for the belief that the claimant has submitted or caused to be submitted to an insurer a suspected false or fraudulent claim as specified in…”
People ex rel. Monterey Mushrooms, Inc. v. Thompson, 136 Cal. App. 4th 24 (Cal. Ct. App. 2006).
“2 According to the complaint, Thompson, who had been convicted in 1997 of seven counts of filing false workers’ compensation claims (Ins. Code, § 1871.4, subd. (a)(2)), had organized two corporations, Peninsula Medical Group, P.”
Cal. Insurance Code § 1871.4(a): 1 case
Pac. Gas & Elec. Co. v. Superior Court, 144 Cal. App. 4th 19 (Cal. Ct. App. 2006).
“7(c), where there is a reasonable basis, supported by specific information available for review by the California Department of Insurance, for the belief that the claimant has submitted or caused to be submitted to an insurer a suspected false or fraudulent claim as specified in…”
Cal. Insurance Code § 1871.4(a)(1): 3 cases
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