Insureds making doubtful claims saved the Particular Investigations Unit (SIU) at Manitoba Public Insurance coverage (MPI) busy all through 2024.
“Their arduous work of detecting and combatting fraudulent claims has contributed to MPI closing 3,548 investigations in 2024,” Maria Campos, MPI’s vp and chief buyer and product officer says in a press launch.
Of these investigations, 5 standouts prompted MPI to subject rundowns of its SIU’s Prime 5 fraud investigations for the yr. MPI estimates the investigations saved Manitoba ratepayers $15 million {dollars} in tried auto frauds this yr.
Store ’til you drop
After a minor auto accident, a claimant stated they might barely stroll, couldn’t bend, squat, transfer their neck or transfer their proper arm, and couldn’t stand for greater than 5 minutes. The accidents made driving extraordinarily troublesome.
The claimant added their accidents required residence help for all duties — getting dressed, shifting via the house, climbing stairs, bathing, toileting, cleansing, laundry, cooking and attending to medical appointments. They claimed restricted mobility made purchasing unimaginable and that they had been unable to work and is perhaps unable to renew employment.
An SIU surveillance effort noticed the claimant purchasing on quite a few events, carrying luggage in every hand, and “energy strolling across the mall.” SIU workforce members noticed no proof of problem strolling, neck motion, standing or utilizing the correct arm. “The one time the claimant was seen to have problem was once they attended medical appointments, after which they’d go looking for hours with no points,” MPI notes in a press launch.
The investigation led to cessation of revenue substitute and private care advantages, and a compensation of practically $5,000. MPI estimates the lifetime financial savings to ratepayers at $1.8 million.
Underneath fireplace
An individual checking on their uninsured automobile parked in a vacant lot was instructed by a passing bike owner to maneuver the automobile. In response, the particular person went to an MPI dealer to acquire a five-day non permanent coverage for that automobile so they might transfer it.
Upon returning to the automobile to gather private belongings, the claimant asserted one of many automobile’s home windows “was all of a sudden shattered by a suspected gunshot.” The claimant fled the scene, and minutes later, firefighters and police had been known as as a result of the automobile’s inside was on fireplace. They discovered no proof of gunfire.
SIU decided the hearth loss was reported 45 minutes after the five-day non permanent coverage was bought. Safety cameras recorded the claimant subsequent to the open automobile six minutes earlier than the hearth was reported. SIU additionally decided the automobile had been stripped of a number of components and wasn’t drivable. No different witnesses reported a gunshot, and the “claimant clarified that they believed they had been focused by a sniper utilizing a silencer,” MPI says. Denying the declare saved ratepayers nearly $9,000.
Animal magnetism
A registered automobile proprietor claimed to have hit an animal (both a rabbit or coyote) whereas driving 50 km/hour. “The motive force reportedly swerved left to keep away from hitting the animal after which swerved proper to get again within the correct lane, at which era they hit the curb, flipping the automobile,” MPI says.
SIU’s investigation obtained onboard knowledge displaying the automobile exceeded 100 km/hour with 100% acceleration, adopted by arduous braking and swerving on the time of collision. Whereas the claimant initially insisted the automobile by no means exceeded 50 km/hour and that their licensed little one was additionally within the automobile, they later admitted their little one had taken the automobile with out permission.
It wasn’t decided whether or not avoiding an animal triggered the accident, however denying the declare saved ratepayers nearly $33,000.
Phantom menace
A two-vehicle early morning collision on a Manitoba freeway triggered one automobile to roll over, and injured each drivers. The motive force of the automobile that didn’t roll, and who made the declare, stated on the hospital that they had no reminiscences of the incident.
SIU’s investigation discovered the driving force of the automobile that rolled noticed a automobile approaching rapidly from behind and assumed it will go round and move. “Nonetheless, the automobile approached at a excessive fee of velocity and struck the automobile, inflicting it to hit the median and roll. A passerby known as 911,” MPI’s press launch says.
The claimant stated they weren’t of their automobile as a result of they’d consumed loads of alcohol and that an individual had come to the residence the place they had been after which drove the claimant’s automobile, inflicting the collision.
However SIU discovered the passenger-side airbag within the claimant’s automobile didn’t deploy and knowledge confirmed the entrance passenger seat was not occupied on the time of collision and that the automobile had been going 180 km/hour. Additional, the claimant was confirmed to have a blood alcohol content material over the authorized restrict.
The declare was denied, saving ratepayers nearly $10,000.
Oh deer
A buyer made a declare after hitting wildlife on the freeway whereas coming residence from grocery purchasing. Whereas deer hair was current, the automobile’s body injury wasn’t in step with a deer collision. It extra carefully resembled a collision with a pole. The automobile was totalled.
The claimant instructed MPI they had been travelling roughly 110 km/hour “when a deer got here from the correct facet of the street and impacted the entrance of the automobile,” says MPI’s press launch. “They additional said that there was no different collision that came about with any vertical or fastened object.”
A mechanical inspection decided the injury resulted from two distinct collisions — one with the alleged wildlife and the opposite with a hard and fast object like a pole. “The false wildlife collision was used as a possibility to disguise the in depth injury that pre-existed,” MPI says, and the declare denial saved ratepayers round $13,600.
Function picture by iStock/medtide
