What is the test for determining whether a defendant knowingly made a false or fraudulent statement under Insurance Code section 1871.4, subdivision (a)(1), for purposes of obtaining workers' compensation benefits?

California, United States of America


The following excerpt is from People v. Lopez, D068570 (Cal. App. 2016):

The record shows the jury was properly instructed that it had to find beyond a reasonable doubt that defendant knowingly made a false or fraudulent statement under Insurance Code section 1871.4, subdivision (a)(1), for purposes of obtaining workers' compensation benefits arising from the November 2009 accident. (Compare People v. Simon (1995) 9 Cal.4th 493, 522 [imposing a knowledge and scienter requirement in connection with Corporations Code section 25401, which, unlike Insurance Code section 1871.4 at issue here, did not expressly require knowledge of the false or misleading nature of a statement or omission to disclose as an element of the unlawful act it defined].)

Moreover, as we have just found, the jury was properly instructed that the false or fraudulent statement must be materialviewed from the perspective of an insurerand that, when defendant made the statement, he had the specific intent to obtain workers' compensation benefits. (See People v. Dieguez (2001) 89 Cal.App.4th 266, 279 [rejecting contention court had a sua sponte duty to instruct on the element of specific intent to defraud for purposes of obtaining workers' compensation benefits because the " 'intent to defraud the insurer is necessarily implied when the misrepresentation is

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