Insurance fraud is an issue that can really cost ratepayers, and Manitoba Public Insurance (MPI) works to ensure that doesn't happen.
During 2022, the MPI Special Investigations Unit (SIU), investigated thousands of claims, saving millions for ratepayers says Marnie Kacher, Chief Operations Officer for MPI.
“Our SIU team works tirelessly to investigate suspicious claims in order to ensure the right claims are paid and for the right amount. Thanks to their dedicated efforts in 2022, MPI closed nearly 3,000 investigations, which resulted in claims savings of over $14 million for customers.”
MPI has compiled a list of the top five fraudulent claims, in which the SIU was able to save ratepayers almost half a million dollars. The top five feature lies about stolen vehicles, exaggerated injury claims, and inconsistencies between police reports and insurance claims.
Claim 1: After reporting to both police and MPI that their car had been stolen, this policyholder signed a sworn statement that the vehicle had been stolen and destroyed by fire.
When the car was found, there was a plastic container used to hold laundry detergent pods nearby. Further investigation found that the claimant and the vehicle were seen at a gas station earlier in the day, filling up the container with gasoline.
When confronted, the person confessed that the fire was an accident and the vehicle wasn't stolen. The claim was denied, saving ratepayers approximately $24,400.
Claim 2: 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, or 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 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, saving ratepayers more than $300,000.
Claim 3: The claimant says they returned to their vehicle and found that it had been damaged by a semi-truck, and said the other driver had already reported the incident to MPI.
SIU's investigation determined that the two people were known to each other, and often interacted on social media. A search of the vehicle also found jugs of coolant and oil in the back seat, and after a full inspection, it was discovered that the engine had seized due to a lack of oil.
The second driver confirmed they intentionally hit the vehicle with a rented moving truck when interviewed, and the claimant later admitted to staging the incident. The claim was denied, saving ratepayers more than $50,000.
Claim 4: After a single-vehicle rollover, three intoxicated people were found by law enforcement outside of the vehicle with no way to determine who had been driving, though the vehicle was registered to one of the individual's spouses.
One of the individuals was arrested for intoxication and held overnight. They were released the next day without any charges.
A few days later, the person that had been arrested opened a claim with MPI saying they had hit a rut and lost control, leading to the rollover. They also claimed that they were alone and hadn't consumed any drugs or alcohol in the past 24 hours.
The claim was denied due to the false statement provided, saving ratepayers an estimated $62,000.
Claim 5: A person claimed that their vehicle had been stolen from their work while they were working an overnight shift. They told police they were only in possession of one set of keys after losing the second set.
While filing their claim with MPI, they stated that they still had both sets at the time of the theft. The vehicle was found, and the immobilizer was functioning as designed. 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.
