SGI’s top five insurance fraud cases; some of the strange and notable insurance claims from the past year

Fighting insurance fraud is important because it helps keep the cost of insurance down for customers.

Unfortunately, there are people who work hard to deceive their insurance company, and SGI works just as hard to stop fraudulent insurance claims.

March is Fraud Prevention Month and we’re highlighting some of the more notable claims examined by SGI’s Special Investigation Unit (SIU).

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

The fraudsters would have gotten away with it, too, if it wasn’t for the work of the SIU and other SGI employees.

Here’s a look at five of SIU’s cases from the past year.

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 of a possible impaired driver, driving a vehicle that matched the description of Daphne’s. A woman was reported to be driving. Police were unable to catch up with the vehicle at the time, but hours later, they responded to a complaint of a vehicle that struck three parked cars and was abandoned. When police arrived on scene, the keys had been removed from the vehicle and there was no one 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 of her decision to provide a false statement to SGI, Daphne was also on the hook for the damage to the parked cars. (Driving impaired also voids insurance coverage.)

What a Night for a Theft

Dee* went out of the country on vacation and reported a theft of over $90,000 worth of property stolen, including a significant amount of high-valued jewelry. She claimed that one night while she went out to dinner, she left all her jewelry inside a bag locked in the backseat of her vehicle parked outside of the restaurant. Along with the jewelry, Dee claimed there was also other high-valued clothing and electronics stolen.

Dee purchased replacement jewelry while still on vacation and submitted a claim with replacement invoices.

Throughout the lengthy investigation, SIU discovered the sale invoices for the replaced items and other documents that Dee tried passing off as genuine, were fake. It was also discovered that the expensive jewelry had not been properly imported to Canada.

Investigators began to suspect that the theft never occurred, and she did not purchase any replacement jewelry at all. Investigators concluded that Dee misrepresented herself, and the claim was denied. Total savings: $90,000.

SIU received an anonymous tip, saying they witnessed 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 owner of the vehicle.

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 there were similarities that 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 it was discovered that they were related.

Investigators concluded the vehicles were intentionally damaged to commit fraud.

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

Nowhere to Hide

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

Later, SIU received some tip information about the location of the vehicle. 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 own investigation and Roger was criminally charged with fraud and public mischief.

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

Mind Your Own 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, compared to what is typically seen in a legitimate break and enter case.

Velma was unable to provide receipts for any items, claiming her folder of important papers, including the receipts, were stolen too.

Several inconsistencies were uncovered by the SIU Investigator. Notably, the quantity and kind of food supplies listed didn’t correspond with the size of the deep freezer seen in photos. Velma had also claimed there were items that had been 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 any further details. Velma had moved out since the incident.

Witnesses spoken to revealed they didn’t believe there had been a break-in at all, 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.