Insurance Code – Sec. 1871.2 – Language is mandatory “For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.” Insurance Code – Section 1871.3 – Language is permissive Claim form warnings for automobile thefts must contain that false representations will subject the insured to a penalty or perjury. Labor Code – Section 5401.7 – Language is mandatory “Any person who makes or causes to be made any knowingly false or fraudulent material statement or material misrepresentation for the purpose of obtaining or denying workers compensation benefits or payments is guilty of a felony.” Voluntary on or with check for temporary disability benefits “Acceptance of employment with a different employer that requires the performance of activities that you have stated that you cannot perform because of the injury for which you are receiving temporary disability benefits could constitute fraud and could result in criminal prosecution. If convicted, you could lose your rights to workers’ compensation benefits and face imprisonment for up to five years and a fine of up to fifty thousand dollars ($50,000) or double the amount of the fraud, whichever is greater.”