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Today, we’re giving you a peek into the intriguing world of insurance fraud

Sunday, June 10th, 2018

| Mar 16, 2018 |

SGI’s Special Investigations Unit (you DID know we have a Special Investigations Unit, right?) compiled a list of some of their more memorable or interesting cases of the past year.

Fibbers get found out when insurance fraud investigated

He thought a little creative deception could help him scam SGI for $25,000, but one missing piece – a valid postal code – unraveled his plan and voided his entire insurance claim.

That was just one of several files SGI’s Special Investigation Unit (SIU) closed in 2017, saving more than $7 million. The team investigates suspicious insurance claims. Their work helps keep insurance rates low, which benefits all SGI customers – except for the ones who try to commit insurance fraud.

March is Fraud Prevention Month in Canada, and SGI reminds customers that insurance fraud is a problem that costs the insurance industry – and ultimately its customers – millions of dollars every year. Making a false or exaggerated insurance claim jeopardizes your coverage and is a criminal offence.

“Unfortunately, property and automobile insurance fraud is still a reality for every insurance company,” said Penny McCune, Executive Vice President and Chief Operating Officer of the Auto Fund. “There’s this misconception that it’s a victimless crime and if it hurts anyone, it’s only affecting a big corporation. But insurance fraud means higher insurance rates for you, your family, friends and neighbours.”

Here are SGI’s picks for the Top 5 Frauds of 2017:

Deceitful receipts

A theft claim was made under an SGI CANADA property policy for a number of expensive items including clothing, computer equipment and jewelry. This fraudster was able to provide several receipts to show the value of the items.

But one receipt in particular raised suspicion; it was for an expensive diamond ring. Most things added up. The jewelry store was legitimate and the address was correct, but it was missing the postal code. In its place was a line that read ZIP CODE.

The cyber-sleuthing skills of SGI’s investigator led to an online receipt generator. Sure enough, the format of the online fake receipt was exactly the same as the one provided for the ring. It all started to click: the site was American and wouldn’t accept a six-character Canadian postal code in the five-digit zip code field.

The jewelry store confirmed the receipt was a fraud and the case was closed with a total savings of close to $25,000. The customer’s entire claim was denied, and his name is flagged in SGI’s system as a future risk. His fraudulent actions could also impact his ability to receive coverage elsewhere.

Called out by the car

One vehicle owner dreamt up the perfect story – or so she thought. She claimed someone hit her parked vehicle and then took off. . . but her vehicle’s onboard computer told a different tale.

Thanks to information downloaded from the Event Data Recorder (EDR) – something most vehicles have today – the investigator learned not only was the vehicle moving at the time of the collision, but the collision also happened on a completely different day than the owner initially reported.

When presented with the findings, the vehicle owner withdrew the claim. Catching the owner in a lie saved SGI, and ultimately its customers, more than $8,000.

Caught on camera

A local business’s video surveillance system saved $14,000 in claim costs.

The vehicle owner said his vehicle was stolen and then found damaged near a local business. SGI’s investigator located a security camera at the scene and reviewed footage from the night of the “theft.” It clearly revealed the owner himself driving the already-damaged vehicle and parking it in the exact spot it was found.

SGI denied the claim and the vehicle owner is facing criminal charges.

A smokin’ scam

In the early morning hours, police and fire services responded to a call of a burning vehicle. The owner claimed he had no idea who would want to vandalize the vehicle.

But the pieces started to fall into place with a neighbour’s tip. Soon it was obvious there was something suspicious about this fire.

Thanks to the neighbour’s willingness to share their security camera footage (they really are everywhere!), the investigator watched an individual approach the vehicle and tinker under the hood for a few moments before leaving the scene. The video showed the vehicle go up in flames moments later. Further investigation connected the owner of the vehicle to the fire.

The owner’s claim was denied, saving an estimated $8,000, and on top of that he’s facing criminal charges.

Hot tip exposes arson

A logging truck broke down on the side of a highway in Northern Saskatchewan. According to the owner, they returned later to have it towed and found it completely burned.

Not long after the claim was made, SGI received an anonymous tip that the owner had intentionally set the truck ablaze. The burnt remains were examined and the investigator found clear evidence the fire was intentionally set. Further investigation confirmed the owner was behind the scam.

SIU looks into every tip they receive, and this one helped to expose a $60,000 fraud. The owner was also charged criminally.

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Take it from these would-be fraudsters: if you commit insurance fraud it leads to denied coverage and could result in criminal charges. It also means you’re flagged in SGI’s systems as a future risk, and can make it difficult to receive coverage from other insurers. On top of all that, the bill to fix that “stolen and damaged” property or vehicle is now the attempted fraudster’s responsibility.