A customer who claimed amnesia following an auto collision and another who said their symptoms were so severe they were unable to work were among Manitoba Public Insurance’s (MPI) Top 5 fraud claims of 2023.
Every year, it’s estimated auto insurance fraud costs Manitoba customers about $50 million, the government auto insurer said in a Dec. 29 press release. In 2023, MPI’s special investigations unit (SIU) closed more than 3,000 investigations, resulting in claims savings of more than $10.5 million for customers.
“Our experts in SIU investigate suspicious claims to give customers the peace of mind that the right claims are being paid for the right amount,” said Satvir Jatana, MPI’s chief customer officer.
Here are MPI’s Top 5 fraud claims of the year, ranked in order from costliest to least expensive for consumers.
No. 1: Memory lapse
A customer opened a collision claim for their vehicle but couldn’t confirm what occurred to cause the damage. They reported they were only made aware of the need for repairs when they went to an impound lot to obtain their belongings from the vehicle. They also denied consuming any alcohol, drugs or medication in the 12 hours before the incident.
But MPI received information the same vehicle was seen driving erratically, damaging property, colliding with another parked vehicle and nearly hitting a pedestrian. “There were also reports the driver was seen stumbling around after the collision and seemed impaired,” MPI said. “Open drugs and alcohol were also seized from the vehicle by the police.”
When interviewed by SIU, the driver maintained no recollection of the incident, claimed they were not impaired and had no knowledge of how they sustained damage to their vehicle.
MPI denied the claim on the basis of making a false statement. The estimated cost savings for ratepayers was more than $60,000.
No. 2: Lifting lies
A claimant receiving benefits reported neck, shoulder and arm pain, as well as dizziness, nausea and headaches that made them unable to work. The individual said their injuries prevented them from walking or driving more than 30 minutes at a time and lifting more than five pounds.
But surveillance showed the customer performing a number of physical activities, including carrying a full water jug that weighed more than 40 pounds. They were also observed shovelling snow, operating a wand pressure washer, as well as lifting, carrying and loading a step ladder into their vehicle.
“Additionally, the claimant was seen running after a garbage truck, shopping and driving a vehicle on several occasions with no indication of pain or dizziness,” MPI reported.
The claimant’s entitlement to income replacement benefits ended because of the investigation, saving ratepayers more than $57,000.
No. 3: Sneaky keys
An insured opened a total theft claim, reporting they woke to find their truck had been stolen overnight. They told MPI two keys existed for the vehicle — the known key was in their possession and no one else had access to it, but the other key was missing.
According to MPI, the insurance for the vehicle was set to expire the day after the alleged theft took place. The customer had already removed the licence plates and was not planning on renewing the policy.
The customer reported the theft to the police, but said they were only given one key when they purchased the vehicle. Police contacted SIU investigators after they recovered the truck one day after it was reported stolen. It had been involved in a single-vehicle collision rollover. There were no occupants, and no keys were found in the truck.
A mechanical examination revealed two keys were programmed for the truck. The key turned in by the customer “had been smashed and unable to be used in the investigation,” MPI said. “Tellingly, the examination also found that the truck ignition, column and immobilizer were intact – meaning that a programmed key was needed to start and run the truck.”
Data showed that prior to the crash the truck was started with a programmed key.
The claim was denied based on the policyholder making a false statement, saving MPI ratepayers approximately $43,600.
No. 4: Need for speed
The insured reported a single-vehicle collision claim, alleging they hit a bump in the road and lost control of their luxury vehicle while travelling the posted speed limit of 60 km/h. Unable to regain control, the driver said the car turned sideways and both driver-side tires hit the curb.
An SIU investigation determined the vehicle damage was too severe for the speed the driver claimed they were going. In fact, data recovered from the vehicle showed the driver was travelling 181 km/h at the time of the collision.
The driver had their licence suspended. The estimated savings from the denied claim was more than $42,000.
No. 5: Unsupervised driver
The driver reported they were travelling with their spouse as a passenger when they rear-ended another vehicle. They stopped to exchange information with the other driver.
But further investigation and a statement from the other driver showed the first driver was alone in their vehicle, despite licence restrictions requiring them to have a supervising driver with them at all times.
When asked to exchange information, the unsupervised driver had their spouse come to the accident scene to do so on their behalf. The couple denied any wrongdoing when questioned by SIU investigators and collision data was unable to support their accounts.
The claim was denied based on the policyholder making a false statement. Savings to MPI ratepayers was approximately $10,200.
Feature image by iStock.com/ardasavasciogullari