SGI releases list of top insurance fraud cases

March is Fraud Prevention Month, so SGI highlighted some of the more memorable claims that its Special Investigation Unit examined.

In 2023, SGI’s Special Investigation Unit investigated 481 claims. Of those, 263 were fraudulent, with an approximate total of $5.9 million.

Here’s a look at four of SUI’s notable cases

Decoy for a Vehicle Theft

A customer we’re calling, Daphne, reported her vehicle stolen. She claimed she may have dropped her keys on the driveway while carrying bags into the house, and the alleged thieves must have found her keys and stolen her car.

Earlier, police had received a complaint about a possibly impaired driver driving a vehicle that matched Daphne’s description.

Police could not catch up with the vehicle then, but hours later, they responded to a complaint of a vehicle that struck three parked cars and was abandoned. When police arrived, the keys had been removed from the vehicle, and no one was around. The vehicle smelled heavily of alcohol and was full of empty bottles.

Several months later, someone tipped off SGI that they overheard Daphne telling her friends she had been intoxicated and hit three parked vehicles. The tipster heard Daphne say she had fled the scene because she was impaired and reported her vehicle stolen the next day.

After further investigation, including witness interviews, SIU determined that Daphne fabricated her claim to avoid the consequences of driving impaired.

When confronted with these findings, Daphne admitted to lying and withdrew her claim, resulting in approximately $50,000 in savings for SGI. Because she decided to provide a false statement to SGI, Daphne was also on the hook for damaging the parked cars.

A Clue for SIU

SIU received an anonymous tip saying they witnessed a customer SGI calling Fred unloading a vehicle towed to the location. Once the vehicle was unloaded, he proceeded to vandalize it. From the witness’s knowledge, they believed Fred was the vehicle’s owner.

The next day, the vehicle was towed away to an unknown destination.

With further investigation, SIU found three different claims involving three separate vehicle owners, but some similarities went beyond coincidence:

  • each vehicle suffered excessive damage;
  • each vehicle was purchased for the same amount, with a similar signature on the bill of sale;
  • each vehicle was listed as a rebuild and
  • all three owners used the same address and phone number as Fred, and they were discovered to be related.

Investigators concluded the vehicles were intentionally damaged to commit fraud.

When confronted with these findings, all three withdrew their claims, saving SGI $13,000.

Nowhere to Hide

‘Roger’ made reports with both the police and SGI, claiming his vehicle had been stolen while he was out shopping. Police thoroughly investigated the complaint, which resulted in some questions about Roger’s story.

Later, SIU received some tips about the vehicle’s location. Roger’s vehicle was located and appeared to have been parked in the same spot for a long time. The SIU investigation revealed that Roger left his vehicle at the location months before and never returned.

The police conducted their investigation, and Roger was criminally charged with fraud and public mischief.

The insurance claim was denied, and Roger must repay SGI $4,300.

Mind Your Break-In

Velma reported a large property loss on her home insurance policy. However, the list of damaged items looked more like someone had moved than what is typically seen in a legitimate break-and-enter case.

Velma could not provide receipts for any items, claiming her folder of important papers, including the receipts, was also stolen.

The SIU Investigator uncovered several inconsistencies. Notably, the quantity and kind of food supplies listed didn’t correspond with the size of the deep freezer seen in the photos. Velma had also claimed items were in the garage, but when an SIU investigator went to the home, there was no garage on the property.

Witnesses were interviewed, including Velma’s landlord, who explained that Velma told them there had been a break-in but didn’t give further details. Velma had moved out since the incident.

Witnesses revealed they didn’t believe there had been a break-in because they saw Velma listing electronics and other household supplies on Facebook Marketplace.

When Velma was asked to come in for an interview to speak further with the investigator to give her a chance to prove her claim, she became defensive and not interested in pursuing the matter further.

The claim was abandoned, and SGI saved $85,000 by not paying out this entirely fabricated claim.

SGI says that when making insurance claims, the important thing to do is always be honest.

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