Canadian Insurance Fraud - Strange But True

Photo Finish: The man's basement had been flooded, causing extensive water damage. The insurance adjuster arrived on the scene and took some pictures for the record. The photos showed a television set, a stereo, and a few bags of clothes that would all have to be replaced. A contractor arrived the next day, and he also took some photos before starting the cleanup. But his pictures told a different story. There were now three television sets instead of one, two stereos -- not one -- and the bags of clothing had multiplied overnight to more than 40. When the adjuster and the contractor compared their photos, they told a story worth a thousand words, but the insurance company only needed two: Claim denied. (top)
Caught on Tape: It seemed like such a clever plan, and an Ottawa man couldn't resist boasting. He was going to arrange for the theft and vandalism of his own car, then collect on the insurance. He thought people would be impressed, so he told someone, who told someone else who, in turn, told the insurance company what was about to happen. Surveillance was arranged and the car owner was caught on videotape handing over the keys to a thief. The thief was then seen faking the theft by damaging the ignition system. He also removed the stereo and returned it to the owner. The owner pretended to be upset at his loss when he filed his claim. However, he became genuinely upset when he was told about the video and charged with fraud. (top)
Garden of Greed: The thieves must have been avid gardeners. A woman said they'd cleaned out her garage and she produced a list of the stolen items that included a riding lawnmower, a garden tiller, chainsaws, shovels, and a whole range of tools. In all, it added up to a $10,000 claim. But she was a little vague about some of the details and descriptions, so the adjuster decided to dig a little deeper. Three neighbours told investigators that they had purchased some of the items from the woman. Her ex-husband told them he'd taken some of the tools with him when he left. And finally, it turned out a few of the things on her list never even existed. Following the investigation, the woman called the adjuster and said she wanted to discontinue her claim.(top)
Mom's and Dad's Idea: A man was going through a messy divorce and decided he needed some friendly female companionship. That's what the ad in the paper promised and apparently delivered. She proved to be a great friend, at least that's what her insurance claim said. She claimed she was helping him home after just meeting him in a bar because he'd had a little too much to drink. She also claimed she'd never been in his house before and that, as she came in the door, she didn't see the basement stairs when she tumbled down and broke her leg. She made a claim against the man and his liability insurer. However, the doctor who lived nearby and had come to treat the woman told a different story. He said he found her, scantily clad, in a heap at the bottom of the stairs. Other neighbours said they'd seen her at the house before the accident. The man confessed that he'd teamed up with his new friend to file a false claim and defraud his insurer, adding it was his parents' idea. There's no word on the reaction of his soon-to-be ex-wife.(top)
The Copycat: It was a run-of-the-mill accident. A man was moving into his new house when he dropped his television set and it tumbled down the basement stairs. He filed a claim and the insurance company replaced the television with a new one. He was obviously impressed with the prompt and efficient service, and he told a co-worker about it. She, too, was impressed, and a little while later, her husband called the insurance company to report that he'd dropped his television set and that he'd taken it to the dump. But the scheming couple had the misfortune of dealing with the same adjuster who had handled the other claim. He went to the dump and discovered that the make, model and serial number of their television set were the same as the one in the earlier case. Coincidence? He thought not.(top)
Blonde Imagination: Two brothers were camping in the mountains of British Columbia when they ran out of beer. They hopped into their Mustang and roared off to a local tavern to restock. While standing at the counter waiting for their order, they bragged to another customer about how fast they'd made the trip. But on the drive back, their luck ran out. The Mustang spun out of control at 150 km/h and crashed into a ditch. The two brothers were thrown out of the car and landed about 50 metres away. When the police arrived, one of the brothers told them that a blonde was driving the car and she ran away after the accident. The brothers filed insurance claims totaling $1.3 million. Perhaps they were imagining how they would spend it when investigators concluded that the mysterious blonde was also a product of their imaginations. Claim denied.(top)
Just the Fax: She must have been a very shy woman. Or perhaps she was just too distressed by the loss of her $72,000 diamond earrings to talk to the insurance adjuster. Whatever the case, she insisted that all contact with her be made by fax machine. Her husband, however, was a little more forthcoming. He told an investigator he knew nothing about the earrings, where they came from or where they went. His wife continued to pursue her claim until one day the insurance company received her final fax. It read: "Unless I hear from you shortly, I will expire my file". Her file is now archived in the no payment section. (top)
Goldfingers: The massage therapist had been busy, but an insurance adjuster thought she had been a little too busy. Investigators interviewed more than 40 of her patients, and reviewed the bills she had submitted to the insurer. It turned out she was offering a kind of two-for-one deal in reverse. The therapist was billing for two massage treatments for every one she actually performed. She was also billing for treating patients while they were out of the country and out of reach. In the end, the massage therapist was touched by the long arm of the law, ordered to make restitution, pay a fine and perform community service. (top)
Transmission Error: A mechanic had suffered a devastating accident. His back and legs were so badly injured that he claimed that he was unable to work. He applied for and received income replacement benefits. For 18 months, the cheques arrived until, one day, the insurance company received a tip. An investigator armed with a video camera was sent to investigate. Sure enough, the mechanic was seen changing the transmission of a car. A car transmission is a very heavy piece of equipment. However, the mechanic had no difficulty pulling out the old one and lifting a new one into place. When the gavel came down, he was convicted of fraud and ordered to repay almost $17,000 in benefits. (top)
Pull the Other One: The injury was real enough. A man's foot had been badly cut, and his story seemed plausible. He'd arrived home, he said, and was getting out of his car when a family member accidentally ran over his foot with a lawnmower. He submitted an accident benefit claim to cover medical expenses and lost income. An investigator went to the man's house and discovered the driveway had high curbs running down both sides. A tape measure and a little math revealed that the man's explanation was impossible unless he had a leg that was 10 feet long. The man withdrew his claim and went back to work without telling anyone what really happened to his foot. (top)
Crash Dummy: A driving instructor had been involved in a car accident. He said his injuries left him unable to drive, and therefore, unable to work, so he filed for accident benefits. But the adjuster noticed that the driving instructor wasn't responding to medical treatment, so he placed him under surveillance. The investigator discovered that the driving instructor was back on the road and had driven over 2,000 kilometres in just three weeks. One of his favorite destinations was the local amusement park, where he was spotted slamming around in bumper cars! Claim denied. (top)
Cell Phoney: The man limped into the local claim centre. He said his foot had been fractured when it was run over in a parking lot, and he filed a claim. But when he left the claim centre, he was spotted on a surveillance camera walking normally and obviously pain-free. On his next visit, he said he was in so much pain he couldn't drive. Later, he hobbled into his physiotherapist's office on crutches, saying the pain was almost unbearable. Following the appointment, the man went into the mall next door. Unfortunately, he misplaced his cell phone and ran around the mall looking for a payphone. He found one, but as he ran up to it, he also ran into his physiotherapist. (top)
Miracle Watch: It was a very expensive watch worth over $4,000, and the man who lost it told a rather fishy story. He said that it must have slipped off his wrist while he was jet-skiing on a local lake. But the details were a little fuzzy. Then there was the fact that he still owed a jeweller for the watch and was demanding a cash settlement from his insurer. The claimant offered to take a polygraph examination, but a few days before it was to take place, he called the insurance company with good news. He'd placed an ad in the local newspaper, he said, asking for the return of the watch. And, surprise, surprise, someone had answered the ad. Apparently, the watch had been found at the bottom of the lake. (top)
The Camera Never Lies: The back and neck pain was agonizing and, he said, he couldn't possibly go back to work. It was a routine claim interview, but the adjuster noticed that the man didn't seem to be suffering very much. A surveillance camera was set up next to a piece of land the man had just purchased, and it soon captured a very fit claimant chopping down trees, clearing brush, and lifting boulders. Claim denied. (top)
Car vs. Roller Blades: Sometimes, it's hard to put the brakes on. That's what happened to one man who was rollerblading downhill. He saw a car ahead of him stopped at a red light, but he couldn't slow down, and bounced off the car. The rollerblader was fine, but, astoundingly, the two people in the car filed for accident benefits, claiming their injuries had left them incapacitated. Although one of the claimants worked for an insurance company as an underwriter, no one believed they could be in such agony while the rollerblader could simply skate away. (top)
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The Overmedicated Pedestrian: A man walking through an intersection was clipped by a car and knocked to the ground. But he got up and refused any help from an ambulance crew. He eventually reappeared at the office of the driver's insurance company to demand compensation. He produced a pile of prescription receipts that totalled well over $2,000. A review of the receipts revealed that he had visited 11 different doctors and over 20 pharmacies. Along the way, he had accumulated so many stress-reducing pills that no one person could possibly take them all and live to tell about it. The claimant was asked to explain. But apparently, the whole issue was too stressful for him, and he was never heard from again. (top)
The Phantom Worker: A woman had been injured in a car accident, and she provided a stack of wage slips to support her claim for benefits. But the adjuster noticed that none of the wage slips included the standard Canada Pension Plan deduction. An investigator visited the employer, who was the woman's brother-in- law. He said she didn't work at his company and never had. Then the investigator showed him the Employer's Confirmation of Income form that had been received from his company. It had been completed and signed by the man's wife. He said his wife was illiterate and couldn't possibly have filled it out. This sister act is now appearing in court. (top)
A Tangled Web: Originally, there was nothing suspicious about the accident-benefit claim. It was paid out and the file closed. Then another claimant from the same car accident demanded compensation. The investigation proved that the second claimant wasn't even in the car at the time of the collision, and it also raised questions about the first claimant. It turned out the accident was minor and there was no damage to the car. The claimant had been paid compensation based on a form supplied by his employer that turned out to be forged. He was convicted of forgery, but before he was sentenced, he was instructed to produce letters attesting to his good character. When he did so, the handwriting turned out to be virtually the same on all three letters, and he now faces three more counts of forgery. (top)
That Sinking Feeling: His beloved Camaro had been stolen and had vanished without a trace. At least, that was the story he told the insurance adjuster and later a judge. Neither of them was convinced. The car was found at the bottom of a local river. The claimant testified that he was nowhere near the scene when the car was dumped. But it turned out that an undercover police officer was. The officer was there on an unrelated case when he saw the claimant and two of his buddies push the car into the water. (top)
Reel to Real: A film crew was working on a television special sponsored by the Insurance Bureau of Canada. The subject of the show was car theft, and the producers had brought in some police officers to offer technical assistance. The officers offered to show them how to find the tell-tale signs that a vehicle had been stolen, and they used the crew's rental van for their demonstration. It proved to be a very informative exercise. You guessed it: the van was stolen. (top)