Insurance Claims That Are Stranger Than Fiction
When things go wrong with homes or cars, insurance can be the one saving grace, but that doesn’t mean you can count on it to bail you out of absolutely anything. Insurance claims adjusters have heard it all, but some things simply aren’t covered. From the mundane to the unbelievable, the job is often like a form of detective work.
Of course, weeding the fraudulent claims out from those that are ridiculous but strangely true at least keeps long days on the job from being dull. Thanks to the commentary of some claims handlers on Reddit, we get to enjoy some laughs and marvel at the truly bizarre. Enjoy!
The Case of the Missing Shed
Probably the strangest claim 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.
Eight months later, the customer went to turn on their tap one day, and no water came out. They went outside, and the 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 to get in the dam with scuba gear to see what was blocking the pipe. He found that the tenant had disassembled the shed and put all of it, including the contents, into the dam.
That’s One Way to Save on Gas
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.
The Sneaky Diamond Heist
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. The lady takes her ring into a different place to get it valued — and the stone was cubic zirconia. The original jeweler swapped it out overnight, didn’t charge her so there would be no paper trail and had since closed up shop. Of course, I always wondered whether the ring was ever a diamond.
“I’m Not Drunk! You’re Drunk!”
One of my favorites was an insured guy hit a telephone pole, and when the police arrived, he was arrested for DUI. According to him, that was a BS charge, because he hadn’t been drinking before the accident.
You see, after the accident, a good Samaritan stopped to see if he was okay. The insured told this stranger that he was okay, but he was thirsty. All the stranger had was some beers. So, he gave them to the insured and left. That’s why he had alcohol in his system when the cops showed up.
Cats Are Falling from the Sky
I found my car one morning with a huge dent on the bonnet. It cracked the servo fluid reservoir underneath, so steering didn’t work either. I was parked next to a 10-story building, and it looked like someone dropped something on it.
I called the cops, and they questioned everyone. It turned out that a resident’s fat cat jumped out the window from the ninth floor and landed on my car. The poor fella broke a leg, but he survived and ran off.
Now, when I filed a claim at the insurance company, I had to talk to dozens of people because they wouldn’t believe what happened. It didn’t really help either that the police report had a sketch of the incident on it — a drawing of a falling cat.
What a Money Pit
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. Here’s the best part: They always paid for these items in cash, and they always bought duplicates. It didn’t take the forensic accountant very long to figure that one out.
Careful What You Post Online
A favorite of mine is a guy who took his giant, customized truck mudding while he was drinking. Against the advice of everyone with him, he drove it into a creek to … well, I’m not really sure why. His truck got stuck, the water levels rose, so he decided to just report the truck stolen. He didn’t think about the fact that there were tons of witnesses and that he posted it on his [social media account].
Driven to Distraction
I worked with 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 (“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 gentleman practicing his kung fu moves on the sidewalk.”
And Suddenly There Was a Car on the Roof
A kid was speeding down a residential street while drunk. He loses control and runs up onto the sidewalk. The way he hit the wall caused it to partially fall and become a ramp that launched him into a full-on boardslide along the roof of the house. It looked like something out of a video game.
Cell Phones and Woodchippers Don’t Mix
A guy came into [electronics store] to get his cell phone replaced under the accidental protection. Apparently, he had his phone in his shirt pocket while putting wood into a woodchipper, and it fell out of his pocket and into the machine. He brought in a bag of sawdust/cell phone dust.
When Someone Takes Those “Good Neighbor” Commercials a Little Too Seriously
We had an older 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 eventually she would let you off.
The most ridiculous story with Alice was when she called to report her car keys were stolen. Her car was still outside her house, but she insisted the gardener broke in and stole the keys. 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 as we are nearing the end of the day, she called to say SHE FOUND THE KEYS UNDER THE BED! She claimed that he (the gardener) must have put them back.
Breaking Up a Fraud Ring
I had a claim that reported a family of seven was struck by a hit and run driver. This particular state didn’t require the responsible party to be identified for the insurance carrier to provide uninsured motorists bodily injury (UMBI) coverage.
I got statements from the husband/father and wife/mother but no statements from the five children because they were all under 10. There was a witness as well, a good Samaritan who stopped and provided her info, so I got her statement. All the statements were consistent. The husband and wife deny ever being in a prior claim, and both the husband/wife and the witness deny knowing each other prior to the accident.
As a good adjuster, I ran an ISO on all parties, and I got pages of matches. It turned out the husband and wife were making a 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. 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). None of those other carriers bothered to check ISO, even though they all ran them through it.
So, I called the husband back, armed with my incredible bounty of knowledge, and had him repeat his statement, slowly this time. I also questioned him a little deeper on things I knew to be lies, like not knowing the witness prior, and 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.
When It Rains It Pours — or Something Like That
I don’t work in insurance claims, but I think my insurance company had a “you’ve got to be kidding me” moment earlier this year. I live on acreage, and our property now has two normal houses on it. Earlier in the year, we had just finished building our second house when we had a fire in it. It was a brand new house, which we hadn’t even moved into yet, just filled with furniture and appliances. The toaster caught fire after the lever had been held down by the appliance cupboard door, and it set the kitchen on fire.
Cue a $200,000 insurance claim from smoke damage through the entire house, replacing wooden floors from water and fire damage, repainting the whole house, replacing all the kitchen appliances, etc. About two weeks before the house that caught fire had the repairs finished, the older existing house flooded. A pipe burst in the bathroom, emptying the contents of the house’s water tank into the house while everyone was at work. Everything was water damaged.
You could almost hear the disbelief in my broker’s voice when I phoned her to let her know my other house was now ruined.
The Downside of Traveling with Everything but the Kitchen Sink
We had a claim for theft outside of a home. The lady said she takes her jewelry everywhere she goes to avoid theft — all $20,000 of it. So, she lodged a claim for theft after 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 stolen were 2 iPads, 2 cameras, 2 iPods and a handbag, which she “didn’t feel like bringing into the party.” Uh-huh.
Welcome to the Snake House
Grandpa worked as a claims adjustor for a fairly well-known company for years. One of the stories I can remember him telling was that shortly after Hurricane Camille, he and a few co-workers went down to Alabama as back up.
He said that he didn’t really know what to expect other than wind and water damage, so that was all that he expected. The supervisor handed him a shotgun and steel-toe boots as soon as he got to the site and told him that he “ain’t expected, asked or wanted in any place first.”
They moved from house to house in teams, and there was a sort of point-man that entered first. Grandpa got the surprise of his life when he walked in the kitchen in one house, and there was a rattlesnake on the counter.
Someone Watched The Borrowers One Too Many Times
My coworker had a claim for theft because little people were living in the claimant’s attic and had a pulley system in her ventilation system. They were coming down through her vents and stealing things like burned down candles, adult diapers, coupons, etc. and hoarding them in her attic. She wouldn’t go in her attic because even though these people were small enough to fit in her vents, she was scared they would attack her.
What a Considerate Thief
When I worked auto claims, I had this lovely older lady make a claim that one of her bridge partners — another older lady — was jealous of her new tires and had her son steal the tires from her car.
The crazy part was that she claimed the lady’s son replaced her new tires with an older version of the same exact tire. So, someone stole your tires and replaced them with the same exact tires?
The Attack of the Turkey
I had a man call last year about a month before Thanksgiving. A turkey had jumped through their picture window. He was laughing, but I could hear his wife in the background crying and the police. Their dog had then fought the turkey, breaking a chandelier, China and the table, and there was blood all over. The dog was fine, but boy was it a mess. It was a shame the turkey didn’t wait until Thanksgiving.
When Insurance Fraud Doesn’t Quite Pan Out as Expected
I got a quote on a customer’s cars, an Audi Q7 and a V8 sport utility vehicle that were both vandalized. Both had all the interiors cut up, silver spray paint all over the dash, broken glass and torn roof lining. The story was that he and his wife had slept in until 10 a.m., and when they woke up and went out to the cars — shock and horror! The cars were both locked, there were no signs of forced entry and keys to both cars were inside.
We did the quote on the cars, the Q7 was touching 30 grand, and the Ute was about 10. The guy wanted the cars written off, not repaired. We found out that both cars had been offered for sale on the net on several sites and hadn’t sold.
Long story short, the police and insurance couldn’t prove anything, but everyone involved was extremely suspicious, but they couldn’t nail it. We have seen more than enough vandalized cars to know this was just off. It looked like whoever had painted and slashed the cars up just didn’t have their heart in it. Once you’ve seen a couple of hundred vandalized cars, you can just tell.
We fixed the cars, and the Q7 ended up hitting nearly $40,000 in parts with all the extras. Three months later, this guy gets his two cars back with all new leather interiors, new dashes, new electronics, new paint and is back at square one — sell the cars.
Does This Policy Cover Damages from Mythical Creatures?
My favorite story was the one about a woman who tried to claim compensation after being “attacked by a vampire.” This Miss-Havisham-looking woman actually sent in a video testimonial in which she sat and described, in a sonorous, mystical sort of voice, how “he enveloped me in his bat-like wings.” Okay, then.
You Have to Admire the Hustle
A customer came in with a four-door Cadillac sedan complaining that he hit “a” pothole and bent all four rims. The rims on the car were fine, and he told me, “No, it’s the ones in the backseat. I had them on at the time and had to put the original ones back on.”
The ones in the backseat were 22-inch Denali wheels that wouldn’t have fit. Even better, there were only two, and I was told that the other two were thrown away, and he would settle for an even $1000.
Never Underestimate the Power of the Wind
I was the source of a kind of strange claim. We had bought a big above-ground pool and were going to install it ourselves because the installers wanted $900. This thing was 26 feet across and had a 4-foot high steel wall. The wall weighed more than 300 pounds. It took me, my kids and one son-in-law to get it properly set up. We decided to fill it the next morning because it was getting late.
That night, a freak windstorm picked up the pool wall and wrapped it around one of our neighbor’s trees 310 feet away (I measured) without touching the grass in between. The insurance guy came out and asked where the pool was. My wife just pointed across the yard at the tree. He said “Okay, then” and left. We got a check a couple of days later. As a bonus, they paid to have it installed since it was installed when it was destroyed, which is kind of cool.
The Horrors of Hoarders
In Maryland, a customer had a pipe break due to freezing. It turned out he was also a hoarder. He had let the water flow in his basement for a day before turning it off. He did nothing to clean it up, and it took a few weeks to get out and see him because he wouldn’t return my calls.
When I got there, I had to step around a dried up pile of puke just to get in the house. Once inside, the smell was terrible. There were cans of food that had rusted out and had rotting contents spilling out. Boxes and boxes of books and papers had been soaking in filthy water, and there were piles of dirty clothes. I got out of there as fast as I could.
Should Probably Work on That Aim
An employee of one of our clients saw a magpie flying past and thought it would be funny to hit it with something, so he threw half of his sandwich at it. In the process of doing this, he caught his hand on the flashing on the roof of the smoking hut next to him. It was apparently his employers’ fault, according to his solicitors.
Well That Escalated Quickly
A worker’s compensation claimant alleged that while she was removing cutlery from the cutlery basket of a dishwasher, she managed to catch her finger for a moment in the basket. This “incident” led to the development of a wrist injury, neurological pain and numbness in the arm, subsequent back pain, post-traumatic stress disorder, agoraphobia and loss of social skills. She hasn’t worked for four years and has cost her previous employer millions.
The Irony of Timing
When I was in college, I called up to start the insurance on my motorcycle. The lady told me the premium was like $291 for the year, but I couldn’t pay monthly unless it was $300. So, I asked how I could just make it $300. She said to add theft coverage, which was like $12, so I did.
Well, it gets stolen five days later from in front of my apartment. They totally thought I was scamming them. I had to do some sort of a financial interview where they wanted to know about all my debt and whatnot. I had to send in all of my bank account statements and credit card statements. Eventually, they approved it.
The funny thing is they found the bike after a couple of weeks because some 19-year-old was trying to chop it in his parents’ backyard, and the dad called the cops. The insurance company tried to convince me to let them reassemble it — the kid had it down to the point where he was selling individual engine parts and starting to sand the body — but I was having none of that. They paid me to replace it.
There Is a Reason for Security Officers
One day, an unsatisfied customer came to the firm with an auto bumper in his hands. He entered through the front doors and threw the bumper at the information desk. Security guys were shocked and didn’t say or do anything.
He yelled in the building for 5 to 10 minutes and wanted to speak with the claims department manager. The security guys didn’t let him pass through the bars. He yelled for another 5 or 10 minutes then stormed out.
He’s Not Even Dead Yet
My mom worked in insurance for years and has all sorts of stories. A typical story she would tell would be along the lines of: Customer – “I want to start the process of cashing in my father’s life insurance.” Mom – “Okay, can you tell me when your father passed away?” Customer – “He hasn’t yet, but the doctor just told us he probably won’t last the night, so I may as well get started.”
She had loads of stories like this, from the recipient of the claim asking about payout while the person was in for routine surgery to the insured dying just a few minutes before. Some people called even if there was nothing wrong with the insured, just to ask about the way the person has to die for the policy to pay out.
Paranormal Activity Is Covered, Right?
We had someone claim a poltergeist had destroyed their furniture. I had to inform them that supernatural occurrences are not covered by the policy. Bummer.