State Disability Insurance (SDI) defines disability insurance fraud as any claim for SDI benefits where a person, alone or in collusion with any other person, willfully makes a false statement or misrepresentation, or withholds a material fact for the purpose of collecting SDI benefits. For example, filing a claim with SDI for an injury or illness that does not exist or helping another person file a false claim is insurance fraud.

An individual who commits disability insurance fraud against the SDI program may be disqualified from receiving further benefits for the current claim and future claim(s), and may be liable to repay a 30 percent penalty in addition to the overpayment amount. Any person who falsely certifies to his/her medical condition or to the medical condition of any other person is subject to an additional 25 percent penalty on any overpayment made due to the false medical. If criminally prosecuted, the individual may face additional penalties.

Disability insurance fraud as defined by State Disability Insurance (SDI) is any claim for SDI benefits where a person, alone or in collusion with any other person, willfully makes a false statement or misrepresentation, or withholds a material fact for the purpose of collecting SDI benefits.

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updated: ts