Social media likes and a laundry detergent container played a part this year in catching Manitoba insurance fraudsters. Every year Manitoba Public Insurance (MPI) releases the top 5 insurance frauds that took place in the last 12 months.
Insurance fraud is never a good thing because in the end, the money comes out all insurance payers pockets. In Manitoba, fraud equates to approximately $50 a year for each customer.
Fraudulent and suspicious claims are handled by Manitoba Public Insurance’s Special Investigation Unit (SIU).
“Our SIU team works tirelessly to investigate suspicious claims in order to ensure the right claims are paid and for the right amount,” says Marnie Kacher, Chief Operations Officer, MPI. “Thanks to their dedicated efforts in 2022, MPI closed nearly 3,000 investigations, which resulted in claims savings of over $14 million for customers.”
Altogether, the investigation and discovery of these top five fraudulent claims by MPI’s SIU saved Manitoba ratepayers nearly half a million dollars in 2022.
Anyone knowing someone who is involved in auto insurance fraud is encouraged to call the Manitoba Public Insurance TIPS Line: 204-985-8477 or toll-free 1-877-985-8477. All calls are anonymous.
5. A Key Story
A person opened a theft claim on their vehicle, reporting that their SUV was stolen from their place of employment during an overnight shift. While speaking with law enforcement, they noted that they were in possession of one set of keys, after misplacing the only other set. However, when filing a claim with MPI they said they had both sets of keys at the time of the alleged theft.
The vehicle was recovered and towed to the MPI compound where it was examined by technicians. The examination concluded that the installed immobilizer was operational and functioning as designed. A coded and programmed transponder radio frequency signal is required to enable the engine to start and remain running, therefore a programmed key is the only way to start the vehicle. Additionally, the investigation found that the vehicle ignition was not manipulated or damaged.
As both sets of keys were determined to be in the customer’s possession despite the initial conflicting reports, the claim was denied, saving MPI’s ratepayers over $38,000.
4. Impaired Interpretation
After being involved in a single-vehicle rollover, three heavily intoxicated people were found by law enforcement outside of a heavily damaged truck with all of the air bags deployed.
There were no witnesses to the incident and law enforcement had no way to determine who was driving the insured vehicle. However, one individual provoked more suspicion than the others, as the truck was registered in their spouse’s name.
One of the individuals was arrested for intoxication, held overnight and released the next day without any charges. Days later, the same person opened a single vehicle collision claim with MPI, indicating that they had hit a rut, lost control and rolled the vehicle. They also claimed they were alone in the truck and had not consumed any drugs or alcohol in the previous 24 hours.
After receiving a sworn statement from the individual, the claim was referred to the SIU, who quickly learned that the police had attended the scene. The claim was denied due to the false statement provided, saving ratepayers an estimated $62,000.
3. Fibbing Friends
An insured individual reported returning to their vehicle to find it damaged by a nearby semi-truck. They also said that the other driver had already reported the collision to MPI and accepted liability for the collision.
After further investigation by the SIU team, it was discovered that the two people were known to one another and often interacted publicly on social media networks. A search of the damaged vehicle revealed jugs of coolant and oil in the back seat and after a full inspection, it was determined that the vehicle’s engine had seized due to lack of oil. The repair cost for the severe mechanical issues was anticipated to be $45,000.
When interviewed, the second driver confirmed they intentionally hit the vehicle with a rented moving truck after being asked for help by the vehicle owner. The owner also admitted to staging the collision.
Denying this claim saved ratepayers over $50,000.
2. Inflated Injuries
After having their vehicle hit while another driver was changing lanes, a policyholder was deemed eligible to receive income replacement benefits and personal care assistance through MPI’s Personal Injury Protection Plan, based on the extent of their injuries.
The person claimed their injuries included a concussion, headaches, dizziness, back, knee and neck pain, an ankle injury and more. They reported that their ailments were so severe that they could not open water bottles, lift a pen, and had limited mobility due to balance issues, nausea and full body pain. They claimed they could barely get out of bed.
An investigation was initiated, and surveillance showed the person was much more active than they reported to be. They were observed walking long distances, including shopping for hours at several stores, lifting bags of groceries, and driving a motorcycle on multiple occasions.
Based on the investigation, the individual was informed that their benefits would be terminated. MPI saved ratepayers more than $300,000 by denying the claim.
1. Dirty Laundry
After reporting to police and MPI that their vehicle was stolen from their home, a policyholder signed a sworn statement to an MPI adjuster claiming that the insured vehicle had been stolen and was destroyed by fire.
When found, a plastic container used to hold laundry detergent pods was located near the burned car.
After further investigation by law enforcement and SIU, reports surfaced that the claimant and the car had been spotted earlier in the day at a gas station, filling a similar container with gasoline.
After being presented with the evidence, the individual admitted the fire was accidental and the vehicle was not stolen as stated in their original statement.
The claim was denied based on the policyholder making a false statement, saving MPI ratepayers approximately $24,400.
