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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.

 

She Wanted Money For Contracting An Infection

From Redditor /u/zOSguru:

I worked in IT at an insurance company. The claim that made the rounds was a homeowners policy where a guest filed a claim against the homeowners policy because she caught [an STI] from his [adult] toys. Claim was denied.

Tenants Took An Entire Shed And Its Contents

From Redditor /u/dannyr:

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 eight 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 [it] was sucking nothing up, meaning there was a blockage somewhere.

The customer went through all the motions, the final step being “get in the dam with scuba gear (the dam was something 4,900,000 L, 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.

A Jeweler ‘Fixed’ A Woman’s Diamond Ring, Replacing It With A Fake

From Redditor /u/horsehome:

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 jewelers; 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 in to a different place to get it valued. Turns out the stone is a cubic zirconia. 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.

A Woman Called Insurance Every Time She Ran Out Of Gas

From Redditor /u/discoveri:

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.

Someone Claimed A Lady Friend Mugged Him And Took All Of His Receipts

From Redditor /u/coffee-and-flowers:

I work in homeowners claims. Here [is one I heard], “I picked up a lady friend from the thrift store. When we got back she drugged me and robbed my apartment. Oh, and she found all my receipts and took them, too.”

A Couple Lost Thousands Of Dollars Worth Of Adult Toys In A Fire

From a former Redditor:

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…

A Man Took Three Shots To Avoid A DUI Charge

From Redditor /u/facthanshotfirst:

I had one where the insured ran a stop sign and hit the claimant. Claimant notices insured is [impaired]. Insured leaves his info and leaves the scene. Cops [go] to his house and [take him into custody]… Insured then states when he got home, he took three shots of liquor to take the stress off and wasn’t drinking and driving.

It was really hard for me having to deny that claim to the claimant. It was a word vs. word – insured was saying claimant ran the stop sign.

A Man Wanted To Get His Condition Treated Through Work Comp

From Redditor /u/USX1234:

Back in the day, I was a claims clerk/coordinator for a big truck company. You know that number you see on the back of big trucks, “Call 800-blah-blah.” That went to my small department. We compiled those into accident claims, work comp reports, and other things. This one night I get a call from a trucker who said he wanted to make a work comp report. Okay, sure, routine thing, glad to try to help out someone who may be hurt and needs it.

First question – are you okay, do you need me to get you to a hospital?

Nah, nothing like that.

Okay, so what’s your injury, where and how did it happen?

Um, it was in my truck, I got it from a lot lizard

This poor guy was trying to make it a work comp claim so he could go to the doctor for his [STI] after his dispatcher gave him hell about wanting to go to the doctor.

A Couple Alleged A Sinkhole Ate All Of Their Valuables

From Redditor /u/ThoughtRiot1776:

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.

A Woman Broke Multiple Public Bathroom Sinks While Engaging In Risque Behavior

From Redditor /u/insurancethrowaway5:

We had a claim for injury for someone that was injured by our sink fixture “magically” ripping itself out of the wall and falling on our claimant causing serious injury. An index search revealed similar claims at several other companies, spread out over the past few years.

Turns out, our claimant seems to have very bad luck with restroom fixtures falling apart and injuring her! Another company who dealt with this claimant in the past was cooperative in sharing their investigation – turns out our claimant has a tendency to not be alone in the restroom.

Needless to say, it had been determined that claimant has a pattern of going into public restrooms to have [adult fun].

A Man Drove His Truck Into A Creek For Fun, But Still Tried To Get Insurance Money

From Redditor /u/seymour__glass:

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.

Someone Got Rear-Ended Because Of Sidewalk Kung Fu

From Redditor /u/Badwater2k:

I worked 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.”

A Kid Keyed His Car To Get A New Paint Job

From Redditor /u/lavender-skies:

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.

Someone Called The Insurance Company And Took Bong Hits During The Conversation

From Redditor /u/prettylittleliams:

Worked in claims for a spell. Some dude was taking [water pipe] hits on the other end. I let him finish, but I laughed a lot. He actually was filing a claim because he ran into his mailbox after brunch.

An Older Woman Made Her Insurance Company Drive Her To The Grocery Store

From Redditor /u/im_reddit_famous:

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.

They Stumbled Upon A Family-Run Insurance Scam Ring

From Redditor /u/pdhot65ton:

I had a claim that was reported: a family of seven was struck by a hit-and-run driver. This particular state did not require the responsible party to be identified for the insurance carrier to provide uninsured motorists bodily injury coverage.

I get statements from the husband/father and wife/mother, and no statements from the five children because they were all [age] 10 or less.

There was a witness as well, good Samaritan that stopped and gave her info. Got her statement.

All the statements are consistent. Husband and wife deny ever being in a prior claim, and both husband/wife and witness deny knowing each other prior to the accident.

So now: as a good adjuster, I ran an ISO on all parties. I get pages of matches. turns out husband and wife make their living off of phantom vehicle claims by filing UMBI and med pay claims for themselves and all five children on a roughly four-month cycle. And, the witness in the claim I was handling was a passenger in their vehicle in a loss about eight months prior. They had at least five prior claims, each with different carriers (all big ones) prior to landing on my desk (a smaller, regional, high-risk carrier) and not of those other carriers bothered to check ISO, even though they all ran them through it.

So, as an adjuster, this is the equivalent of a Fatality in Mortal Kombat, the blowout victory over Michigan in college football, I had in my hands, the [final blow] on a disgusting scam where parents were using their children as pawns in a highly [unethical] insurance [scam] (and honestly, potentially f*cking up their kids futures).

So, I called the husband back and, armed with my incredible bounty of knowledge, had him repeat his statement, slowly this time, and questioned him a little deeper on things I knew to be lies (not knowing the witness prior). [Then I] lulled him into a sense of security before blowing him up with his prior claim history and my company’s decision to refer him to the NICB and contact the other carriers on his ISO letting them know about his fraud and staged accidents.

The silence on the other end was magical. I could hear what was left of his useless soul escaping and begging to be reincarnated into something more noble, like a maggot or a rock.

A Woman Claimed Someone Took Over $20K Worth Of Jewelry And Electronics That She Left In A Virtually Unlocked Car

From Redditor /u/Sharksarescary:

We had a claim for theft outside of her home. This lady said she takes her [jewelry] everywhere she goes to avoid [it being taken]. All ~$20k of it. So she lodges a claim… where she had taken the jewelry and left it in her car while she was at a friend’s party. She parked the car three blocks away in a park and “left” the window down. Also [taken] were two iPads, two cameras, two iPods, and a handbag (which she “didn’t feel like bringing into the party”).

Craziest thing is when we declined her, it was overturned on some bullsh*t technicality, and we had to pay her the claim.

A Man Hoarded Over 17 Pets And Sued For Bedbugs

From Redditor /u/westsideasses:

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.

A Woman Lost Her Ring In A Cow’s Rear End; She Wasn’t Wearing Gloves

From Redditor /u/somebrero:

There was one the other day where the lady lost her ring up a cow’s butt because she was helping it give birth. I don’t know why she wasn’t wearing a glove. There’s always time for a glove.

A Man Slathered A Cream On His Nether Regions And Filed A Claim About The Ensuing Rash

From Redditor /u/porkinator:

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.

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