SECTIONS 11760-11760.1 - California Statutes

INSURANCE CODE

SECTION 11760-11760.1

11760. (a) It is unlawful to make or cause to be made any knowingly
false or fraudulent statement, whether made orally or in writing, of
any fact material to the determination of the premium, rate, or cost
of any policy of workers' compensation insurance, for the purpose of
reducing the premium, rate, or cost of the insurance. Any person
convicted of violating this subdivision shall be punished by
imprisonment in the county jail for one year, or in the state prison
for two, three, or five years, or by a fine not exceeding fifty
thousand dollars ($50,000), or double the value of the fraud,
whichever is greater, or by both imprisonment and fine.
(b) Any person who violates subdivision (a) and who has a prior
felony conviction of the offense set forth in that subdivision shall
receive a two-year enhancement for each prior conviction in addition
to the sentence provided in subdivision (a). 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.

11760.1. (a) If an employer fails to provide for access by the
insurer or its authorized representative to its records, to enable
the insurer to perform an audit to determine the remuneration earned
by the employer's employees and by any of its uninsured
subcontractors and the employees of any of its uninsured
subcontractors during the policy period, the employer shall be liable
to pay to the insurer a total premium for the policy equal to three
times the insurer's then-current estimate of the annual premium on
the expiration date of the policy. The employer shall also be liable,
in addition to the premium, for costs incurred by the insurer in its
attempts to perform an audit, after the insured has failed upon the
insurer's third request during at least a 90-day period to provide
access, and the insured has provided no compelling business reason
for the failure. This section shall only apply if the insurer elects
to comply with the conditions set forth in subdivision (d).
(b) "Access" shall mean access at any time during regular business
hours during the policy period and within three years after the
policy period ends. "Access" may also include any other time mutually
agreed upon by the employer and insurer.
(c) The insurer shall have and follow regular and reasonable rules
and procedures to notify employers of their duty to provide for
access to records, and to contact employers to make appointments
during regular business hours for that purpose.
(d) Upon the employer's failure to provide access after the
insurer's third request during at least a 90-day period, the insurer
may notify the employer through its mailing of a certified,
return-receipt, document of the increased premium and the total
amount of the costs incurred by the insurer for its attempts to
perform an audit as described under subdivision (a). Upon the
expiration of 30 days after the delivery of the notice, collection by
the insurer of the amount of premium and costs described under
subdivision (a), less all premiums previously paid by the employer
for the policy, shall be fully enforceable and executable.
(e) If the employer provides for access to its records after
having received the notice described in subdivision (d), and if the
insurer then succeeds in performing the audit to its satisfaction,
the insurer shall revise the total premium and costs payable for the
policy by the employer to reflect the results of its audit.