Insurance companies protect people when emergencies arise. In theory, people respect insurance agents. Indeed, there is a sacred bond between the policyholder and insurer; the average Joe pays oodles of money and in turn receives help for dire situations. No one would ever abuse that bond – except, however, for the people who do.
To hear some people tell it, insurance companies string quite a few customers along, occasionally even refusing to pay for claims that should have been covered and denying coverage outright to people who genuinely need it. However, some policyholders aren’t all that innocent either. People blatantly lie about their claims to get money from the system.
I've worked in claims related areas for ~10 years. I've done claim processing on a wide range of policies (from Domestic Home and Contents through to Motor Fleet, Commercial Liability, Wheat Crop, Livestock, Fidelity, etc). I'm now a Loss Adjuster (Insurance Assessor) and boy, have I seen some things.
Probably the strangest one I ever saw was a burglary claim. The homeowners had rented their 500-acre property out to tenants, and included in the lease was a shed full of equipment. Tractors, harvesters, work tools, etc. Basically, everything you need to run a farm was in that shed.
At the end of the lease, they took back over the farm and found the shed not only empty but missing. The concrete slab was still there, but nothing else was.
A claim was lodged, a police report was made, and the customer got everything replaced.
However, where it gets strange is the phone call I got 8 months later.
The customer went to turn on their tap one day and no water came out. They went outside and their pump was working but was sucking nothing up meaning there was a blockage somewhere.
The customer went through all the motions, the final step is "get in the dam with scuba gear (the dam was something 4,900,000L, so a fairly big dam) and see what's blocking the pipe" and found that the tenant had disassembled the shed and put all of it, including the contents of the shed into the dam.
We then helped the customer empty the dam and move everything to Auction to be sold off. The profit went back to the Insurer to pay for claims costs.
From Redditor /u/dannyr:
Currently, work in home claims lodgment. My favorite has got to be a call I received a few months ago.
Around a decade ago, this lady took her ring into a jeweler; one of the claws holding the stone was bent out and she wanted to get it repaired. Since the job was small, the jeweler kept the ring overnight, performed the repair, and didn't charge the woman for the job when she came back to pick it up.
Now, back to the present day. Lady takes her ring into a different place to get it valued. The original jeweler swapped it out overnight, didn't charge her so there'd be no paper trail, and had since closed shop.
Of course, I always wondered whether the ring was ever a diamond.
From Redditor /u/horsehome:
This one lady had over 50 towing and labor claims within a six-month period. She would drive until she ran out of gas and then call the tow number. They would come out and give her a few gallons of gas. Then she would drive until she ran out of gas and call the number again. Rinse and repeat.
After six months, they permanently banned her from using that option.
From Redditor /u/discoveri:
We had a house fire claim, so the insureds gave us a spreadsheet with everything they were claiming and replacement prices. This couple had thousands of dollars in [adult] toys, and they even [included] Playboys and Penthouse magazines that were 10 years old and worthless with the depreciation. I mean, I get why you'd want to claim that since it's good money, but damn was it hard to look them in the eye...
From a former Redditor:
There was a couple that had a ton of damage done to their house by a sinkhole, but they were claiming a ton of luxury items, such as jewelry, fur coats, etc., were all lost. And here's the best part: they always paid for these items in cash and they always bought duplicates. Didn't take the forensic accountant very long to figure that one out.
From Redditor /u/ThoughtRiot1776:
Usually the "you've got to be kidding me claims" are ones where I wonder how someone thought they would never get caught filing a fraudulent claim. A favorite of mine is a guy who took his giant, customized truck mudding while drinking, and against the advice of everyone, he was with, drove it into a creek to... well, I'm not really sure why.
His truck got stuck, the water levels rose, and he decided to just report the truck [pinched]. He didn't think about the fact that there were tons of witnesses and that he posted it on his Facebook.
From Redditor /u/seymour__glass:
I worked on auto claims for a while. When we would get a new claim assigned to us, we would review the file including a very brief (one-to-two sentence) description of what happened (the "facts of loss"). My cube-mate got one that said, "insured driver (our customer) rear-ended claimant (other company's customer) after being distracted by a homeless gentleman practicing his kung fu moves on the sidewalk."
From Redditor /u/Badwater2k:
A 16-year-old kid got some craptastic Mustang which needed a paint job. He got a quote and realized hey, it's kind of expensive. Ever so conveniently, his car was keyed. They managed to damage every single panel... while it was parked in a McDonald's parking lot... during the supper rush.
From Redditor /u/lavender-skies:
We had [a senior] British woman who would constantly call our office with the most outlandish requests/claims. She once called and insisted we drive to her house to take her to the grocery store while her car was being worked on. It got to the point where every time we saw her pop up on caller ID, you could just feel the dread fall over the office. Not only would she have ridiculous claims, but she would always want to stay on the phone for ages... you would have to promptly tell her, "Alice, I have to go." Sometimes, you'd have to repeat it a few times, but she'd eventually let you off.
The most ridiculous story with Alice was when she called to report her car keys stolen. Her car was still outside her house, but she insisted [a gardener] broke in and stole them. It was a huge ordeal in which we paid to have her car towed in hopes of getting a new key made for her. However, she didn't remember where she had it towed, and we had to call all over town to track it down. Finally, after we found the car and we are nearing the end of the day, she called to say SHE FOUND THE KEYS UNDER THE BED! Wut.
She claimed that he must have put them back. No, Alice, I don't think so, but okay. She asked me not to tell the office, but of course, I did. She's a pretty awful person, and in a way, I'm glad she couldn't afford her premiums and we don't have to deal with her anymore.
From Redditor /u/im_reddit_famous:
Had a claim for bedbugs in which a guy lived in a small, one-bedroom apartment with eight cats and nine dogs and several other animals (hedgehogs, ferrets, etc.) that he let roam around outside. He had no idea how he could've gotten bedbugs, despite his filthy lifestyle, and when I told him there was no coverage, he told me he was going to "fight for his liberty" and [bring legal charges against] my company.
From Redditor /u/westsideasses:
We insured a company that either manufactured or distributed (I can't remember now) a variety of different pharmaceutical products. One of these products was a cream to help a man's performance in the bedroom. A claimant was attempting to claim against our client because he'd had a bad reaction to the cream, which as you can imagine must have been painful on a man's most delicate area.
The best part, though? He'd done the recommended patch test on his forearm beforehand and received the same result... but then decided to slather it on his nether regions anyway.
From Redditor /u/porkinator: