Insureds making dubious claims kept the Special Investigations Unit (SIU) at Manitoba Public Insurance (MPI) busy throughout 2024.
“Their hard work of detecting and combatting fraudulent claims has contributed to MPI closing 3,548 investigations in 2024,” Maria Campos, MPI’s vice president and chief customer and product officer says in a press release.
Of those investigations, five standouts prompted MPI to issue rundowns of its SIU’s Top 5 fraud investigations for the year. MPI estimates the investigations saved Manitoba ratepayers $15 million dollars in attempted auto frauds this year.
Shop ’til you drop
After a minor auto accident, a claimant said they could barely walk, couldn’t bend, squat, move their neck or move their right arm, and couldn’t stand for more than five minutes. The injuries made driving extremely difficult.
The claimant added their injuries required home assistance for all tasks — getting dressed, moving through the home, climbing stairs, bathing, toileting, cleaning, laundry, cooking and getting to medical appointments. They claimed limited mobility made shopping impossible and that they were unable to work and might be unable to resume employment.
An SIU surveillance effort observed the claimant shopping on numerous occasions, carrying bags in each hand, and “power walking around the mall.” SIU team members saw no evidence of difficulty walking, neck movement, standing or using the right arm. “The only time the claimant was seen to have difficulty was when they attended medical appointments, after which they would go shopping for hours with no issues,” MPI notes in a press release.
The investigation led to cessation of income replacement and personal care benefits, and a repayment of nearly $5,000. MPI estimates the lifetime savings to ratepayers at $1.8 million.
Under fire
A person checking on their uninsured vehicle parked in a vacant lot was told by a passing cyclist to move the car. In response, the person went to an MPI broker to obtain a five-day temporary policy for that vehicle so they could move it.
Upon returning to the vehicle to collect personal belongings, the claimant asserted one of the car’s windows “was suddenly shattered by a suspected gunshot.” The claimant fled the scene, and minutes later, firefighters and police were called because the vehicle’s interior was on fire. They found no evidence of gunfire.
SIU determined the fire loss was reported 45 minutes after the five-day temporary policy was purchased. Security cameras recorded the claimant next to the open vehicle six minutes before the fire was reported. SIU also determined the car had been stripped of several parts and wasn’t drivable. No other witnesses reported a gunshot, and the “claimant clarified that they believed they were targeted by a sniper using a silencer,” MPI says. Denying the claim saved ratepayers almost $9,000.
Animal magnetism
A registered vehicle owner claimed to have hit an animal (either a rabbit or coyote) while driving 50 km/hour. “The driver reportedly swerved left to avoid hitting the animal and then swerved right to get back in the proper lane, at which time they hit the curb, flipping the vehicle,” MPI says.
SIU’s investigation obtained onboard data showing the vehicle exceeded 100 km/hour with 100% acceleration, followed by hard braking and swerving at the time of collision. While the claimant initially insisted the car never exceeded 50 km/hour and that their licensed child was also in the car, they later admitted their child had taken the vehicle without permission.
It wasn’t determined whether avoiding an animal caused the accident, but denying the claim saved ratepayers almost $33,000.
Phantom menace
A two-vehicle early morning collision on a Manitoba highway caused one vehicle to roll over, and injured both drivers. The driver of the vehicle that didn’t roll, and who made the claim, said at the hospital they had no memories of the incident.
SIU’s investigation found the driver of the vehicle that rolled saw a vehicle approaching quickly from behind and assumed it would go around and pass. “However, the vehicle approached at a high rate of speed and struck the vehicle, causing it to hit the median and roll. A passerby called 911,” MPI’s press release says.
The claimant said they weren’t in their vehicle because they’d consumed a lot of alcohol and that a person had come to the residence where they were and then drove the claimant’s vehicle, causing the collision.
But SIU found the passenger-side airbag in the claimant’s car didn’t deploy and data showed the front passenger seat was not occupied at the time of collision and that the vehicle had been going 180 km/hour. Further, the claimant was proven to have a blood alcohol content over the legal limit.
The claim was denied, saving ratepayers almost $10,000.
Oh deer
A customer made a claim after hitting wildlife on the highway while coming home from grocery shopping. While deer hair was present, the vehicle’s frame damage wasn’t consistent with a deer collision. It more closely resembled a collision with a pole. The vehicle was totalled.
The claimant told MPI they were travelling approximately 110 km/hour “when a deer came from the right side of the road and impacted the front of the vehicle,” says MPI’s press release. “They further stated that there was no other collision that took place with any vertical or fixed object.”
A mechanical inspection determined the damage resulted from two distinct collisions — one with the alleged wildlife and the other with a fixed object like a pole. “The false wildlife collision was used as an opportunity to disguise the extensive damage that pre-existed,” MPI says, and the claim denial saved ratepayers around $13,600.
Feature image by iStock/medtide
