Episode 7 Claimed and Shamed


Episode 7

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Transcript


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Insurance fraud has reached epidemic levels in the UK.

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It's costing us more than £1.3 billion every year.

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That's almost 3.6 million every day.

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Deliberate crashes, bogus personal injuries, even phantom pets.

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The fraudsters are risking more and more to make a quick killing and

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every year it's adding around £50 to your insurance bill.

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But insurers are fighting back,

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exposing just under 15 fake claims every hour.

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Armed with covert surveillance systems...

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Subject out of the vehicle.

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..sophisticated data analysis techniques...

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-..and a number of highly-skilled police units...

-Police, don't move.

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-Stay where

-you are! ..they are catching the criminals red-handed.

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Just don't lie to us!

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All those conmen, scammers and

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cheats on the fiddle are now caught in the act and Claimed And Shamed.

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Today, a group of friends that deliberately crash their cars for money are exposed.

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It quickly became apparent that she had lied to us when she told

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us that she did not know the other driver.

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A claimant's attempt to dupe a new device from her phone insurers is blocked.

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And something stinks when a high-end men's tailor claims his stock is

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spoilt by sewage.

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It became apparent that some of this documentation had, in fact, been

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created by Mr L on his own computer.

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More than 35 million of us get behind the wheel in the UK.

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That adds up to a huge number of car policies and a staggering

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£17.1 million is paid out in private car claims every day.

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Statistics like that can be appetising for fraudsters and opportunists alike.

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So, insurance companies are fighting a constant battle to identify

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the genuine claims from those that have been exaggerated,

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completely made up, or have even been the result of deliberate crashes.

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The UK highways are some of the busiest in the world, with motorists

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clocking-up an estimated 314 billion miles every year.

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Mark Chiappino, at Direct Line Group,

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has made it his business to bust the claims of fraudsters.

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He was passed what looked like a fairly typical rear-end shunt accident to review.

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Our customer, Ffion Owen,

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notified us that she had had an accident,

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driving her Ford Focus into the rear of an Audi A4,

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driven by Faizal Saidi.

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This accident occurred on a residential street in Liverpool.

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On the face of it, this appeared to be a genuine accident.

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This is the type of accident that happens hundreds, if not thousands,

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of times every day on British roads.

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It may have been an everyday occurrence,

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but the timing was a little convenient

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as Owen, who had rear-ended Saidi's car,

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only had a week before her policy was due to expire.

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We were subsequently notified of eight personal injury claims from

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the occupants of the Audi and from Ffion Owen's own passengers.

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These claims totalled approximately £38,000.

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With only a week left on her policy and a high number of personal injury

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claims submitted, suspicions were raised,

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which led investigators to probe a little deeper.

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We asked her, as a matter of routine whether she knew any of the occupants of

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the other vehicles and she said that she didn't.

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When the injury claims were presented,

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we carried out further routine searches.

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Our enquiries via social media led us to discover that not only did

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Ffion Owen know Faizal Saidi,

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but that she also featured in several photographs of the two of them together.

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So, they had been proven to have exchanged more than paintwork previously.

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It was damning evidence.

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It quickly became apparent that she had lied to us when she told us that

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she did not know the other driver.

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Having been on the end of a barefaced lie,

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Mark's team were keen to separate fact from fiction.

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We started investigating this accident as a suspicious claim.

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We instructed a forensic engineer to examine both vehicles and gather

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further evidence.

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And it would reveal some very curious discoveries.

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The claim was presented to us as if Ffion Owen had driven into the back

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of the Audi. When the Audi was examined,

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we found damage on both the rear wings and on the rear of the vehicle.

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This is damage that defies the law of physics.

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The clue is in the title.

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Rear-end shunt.

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But those laws of physics continued to be broken.

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There were screw heads protruding from one of the vehicles.

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If there had been a single accident,

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you would expect to find one corresponding mark on the other

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damaged vehicle. However, he found not one, not two, not even three,

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but four corresponding marks on the other vehicle,

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indicating that the vehicles had been collided at least four times.

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Yeah, you don't have to be a forensic engineer to figure out that

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Owen's story was no longer adding up.

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Once we realised that a serious attempt had been made to defraud Direct Line of £38,000,

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we passed the details immediately to

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the police insurance fraud enforcement department at Ifed.

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Ifed snapped up the case and were eager to build on the investigative work

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Direct Line had already done.

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There was already quite a lot of evidence there.

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The circumstances were broadly quite suspicious.

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If these cars had genuinely crashed together,

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there would only be one impact.

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And also there shouldn't really be any kind of links between the

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occupants of either vehicle.

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With the connection between the drivers of

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both vehicles established,

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Oliver had to identify and move in on any other suspects.

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When we looked at all the information we had about this case,

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the most important thing for us was to focus down on

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the key orchestrators. So, Faizal Saidi was driving one vehicle.

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The other vehicle was being driven by Ffion Owen.

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But we also wanted to speak to her boyfriend, Ciaran Hodson,

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because we believed that there was evidence that he was the link

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-between the two.

-Hodson was also a passenger in Owen's car at the time of the accident.

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It was time for Ifed to take this investigation to the next level.

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We went to go and arrest Mr Hodson at his home address.

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When we investigate crash-for-cash cases,

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we're typically looking for anything...

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Any kind of paperwork that relates to the insurance claim.

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Also, we're often looking for phones because they can tell us a huge

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amount about who's been in contact with who,

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and crucially when. And if it's before the date of a collision,

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then that's often telling evidence.

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We came away with quite a lot of paperwork and some phones from his address.

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The phones clearly showed frequent communication before

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the accident between Owen, Hodson and the driver of the other car,

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Faizal Saidi.

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In light of the evidence,

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this Bonnie and Clyde duo didn't last long under interview.

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Fairly unusually for a crash-for-cash investigation,

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both Hodson and Owen fully admitted that this collision had never really

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happened, as they tried to purport to the insurance companies,

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that they'd crashed the cars together to make some money.

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And also because one of the vehicles already had a broken bumper and they

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wanted to get a cheap repair.

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With Owen and Hudson telling all, it was two suspects down, one to go.

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We found Mr Saidi harder to locate.

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More difficult to find and get his account.

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Luckily, some colleagues of ours in a separate police force were also

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looking to speak to Mr Saidi and so we were able to coordinate our

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efforts and track him down.

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So, Saidi was a man in demand.

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But once Ifed had him in custody,

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he wasn't as forthcoming as his partners in crime.

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Mr Saidi didn't want to answer any of our questions.

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But by that stage, we had his phone.

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And so we had plenty of evidence there to show that there had been an

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exchange between Mr Hodson and Mr Saidi of the details of Ms Owen's

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vehicle and bank account details.

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All leading up to the accident date.

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So, we had clear evidence that this was a relatively carefully planned

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and orchestrated crash-for-cash scam.

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That was the final nail in the coffin for our troublesome trio.

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The outcome was that we had compiled a pretty overwhelming case and we

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took that to the Crown Prosecution Service who authorised charges against

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all of these people. And we took them to court and they were all convicted.

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Having pled guilty to fraud by false representation,

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all three were sentenced to 12 months' imprisonment,

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suspended for two years,

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and were each ordered to pay back £3,000 to Direct Line.

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I think what this case highlights is there's a multitude of ways that

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insurers and the police look at crash-for-cash.

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I think it's fair to say that the days of easy whiplash claims and

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quick cash from crashes have gone.

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There's a huge amount of work being done by the industry and the police

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and it's only ever going to get harder.

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Later, the owner of a puppy lies about it's date of death, to obtain

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false insurance cover.

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And a driver's claim his car was sideswiped by a bus breaks down when

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CCTV shows it barely left a scratch.

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Take a look at that.

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The car doesn't even move.

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Now, for most of us, living without our smartphones or tablets just

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isn't an option. Whether you're keeping in touch, working on the go,

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sharing your life with the world,

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or are an online Scrabble addict like me.

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Yeah! The modern day smartphone lets you do it all.

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So, when we lose or break them, it's a big deal.

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And that's why we have mobile phone insurance.

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Luckily, mobile insurers can reconnect us with a replacement handset and

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have us selfieing again before we know it.

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But this service has also been targeted by fraudsters who think

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they can make some easy money.

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In the event of a device disaster, Andy Morris's team are on hand to help.

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All manner of claims come across Andy's desk.

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One particular case he was given to review, presented like a fairly

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standard phone faux pas.

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So, this lady called our claims team and told us that her iPhone had been

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damaged and said that they had dropped the phone on the road and

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the phone had been run over by various vehicles.

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It's not hugely unusual for our customers to drop their phone and

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subsequently a vehicle go over the phone.

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It's quite rare that a phone would be run over by numerous vehicles.

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Indeed, and the claimant explained how her handset was well beyond saving.

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So, at that point, a claims agent offered to swap or repair the

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device for the customer.

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To which they were told quite clearly the phone was in several pieces.

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And what's more, the claimant didn't have time to swap the device.

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Despite a rather smashing story,

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there was no way to validate the claimant's account of what had happened.

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But the claims handler was still prepared to give her the benefit of the doubt.

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So, we gave her the opportunity of claiming for a brand-new handset,

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which we would call a replacement loss.

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We asked for some additional information to process the claim.

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In a normal set of circumstances,

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that information would be processed on the same claim,

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or within minutes or hours.

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Well, this wasn't a normal situation.

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And things took slightly longer than that.

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We heard nothing from this claimant for ten months.

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It's incredibly unusual for there to be such a long gap.

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To be without the handset is equivalent

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to losing an arm or a hand.

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That's a wait of nearly a year to complete the claim for her destroyed device.

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While the claimant was in no rush,

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Andy's team had plenty of time to look into her phoney story.

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Whilst processing the claim and gathering the information and the

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evidence, our claims handling agent

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found evidence that this unique device

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had been exchanged directly with a manufacturer before the original

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claim had been notified to us.

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Andy's team had proof that the claimant had exchanged the phone

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reported to be damaged, some ten months ago

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and had already received a replacement handset.

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This information was put to her.

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The claimant might well be on the back foot.

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Andy's team have established that the allegedly smashed device was

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exchanged for a brand-new one ten months ago

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courtesy of the phone manufacturer.

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As her phone number would have transferred over to any new phone she was given,

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Assurant could see she had been using the replacement handset all along.

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Quite clearly in this case, the claimant stood to profit

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because she had already

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replaced the phone and she was then subsequently claiming for a new phone.

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So, she would have profited because the result would have been two devices.

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Even faced with the evidence,

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the claimant was determined to play dumb.

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During the claims process, our agent gathered the evidence

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not only that this handset had been exchanged,

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but also the mobile phone number and the individual claimant's

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information was exactly the same.

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In short, the evidence suggested the claimant was trying to claim for

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a phone that had already been replaced.

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But the curious gap of ten months before she even attempted to claim

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with her insurers, gave Assurant cause for concern,

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as well as time to investigate, allowing them to uncover key information.

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At this stage,

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the evidence that we'd gathered during the claims process made it

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pretty unequivocal that the original story

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that the handset had been dropped in

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the road and run over by various vehicles actually had no fact.

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But there was no budging the claimant from her version of events.

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We had evidence to prove that the handset had been swapped.

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So, during the call,

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on supplying the information and the evidence to this claimant,

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the lady merely said, "OK, all right, thanks."

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And just like that, the ongoing 10-month claim was over.

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The claimant's willingness to throw in the towel, strongly suggests she

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thought pulling a fast one would be easy as one, two, three.

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What's incredible about this case is the behaviour of the claimant.

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They probably don't realise that every conversation, or every interaction,

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is recorded. So, what that means is our ability to detect fraud,

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even though it might be ten months later, is greater.

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Now, you probably have never wondered what an insurance cheat looks like,

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but I can tell you they come in many guises from all manner of

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backgrounds. The truth is,

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not all fraud is committed by what you might consider

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out-and-out criminals. In fact,

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there are often individuals in respected positions who have no history of criminality,

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but for whatever reason decide to go down a dishonest path.

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RSA's John Beadle picked up the thread of a case which needed some

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further investigation, back in 2009.

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This was a claim from a gentleman who had been a loyal customer of

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ours for some time, in respect of his commercial property,

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which was a rather exclusive Central London menswear shop.

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And he made a claim in respect of water damage

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caused at his commercial premises,

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which had damaged both his stock and

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his personal clothing.

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On the face of it, this was a genuine claim,

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which we settled relatively quickly with a cash payment of £30,000.

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But unfortunately, the claimant's bad luck soon struck again.

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Some years later, Mr Elle made another claim where sewage had escaped into

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his commercial premises and had damaged again both his

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commercial stock and also his personal effects.

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The value of this claim was some £39,000.

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With Mr Elle's high-end suits ruined and reeking,

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the conditions of the claim were also a little whiffy.

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This being the second occasion with very similar circumstances,

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it would prompt us to look a little closer, which is indeed what we did.

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John's team were determined to wring out the truth.

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We asked Mr Elle to substantiate the claim and give us a list of the items

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which had been damaged and these

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were really expensive pieces of clothing.

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He produced to us some documentation to support his claim.

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When we examined this,

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we found actually it bared very similar relationship with the original claim.

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Whilst not quite a duplicate of it,

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it appeared to contain items which were the same.

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Highly suspicious that the two

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claims bore such startling similarities,

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the paperwork Mr Elle had supplied was analysed for any discrepancies.

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It became apparent that some of this documentation had in fact been

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created by Mr Elle on his own computer

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the day before the visit by our

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investigator and no doubt in preparation for his visit.

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With strong evidence that Mr Elle had submitted a fraudulent claim,

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it was time to air his dirty laundry in public.

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We confronted Mr Elle with our difficulties

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we had in respect of the claim

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and the supporting documentation

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and he offered no reasonable explanation.

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We certainly weren't going to pay the claim and in fact we referred

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the case to Ifed.

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The Insurance Fraud Enforcement Department took the case on

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and after reviewing the evidence and interviewing Mr Elle,

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it wouldn't be long before he would need one of his own suits for

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a very formal occasion.

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Ifed picked up our investigation and ultimately charged Mr Elle

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with two counts of fraud.

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He went to crown court,

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where he pleaded guilty and he was sentenced to

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ten months' imprisonment, suspended for 12 months,

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and ordered to do 160 hours of community work.

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Mr Elle had narrowly escaped a custodial sentence.

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But RSA still had unfinished business with him.

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In addition to the prison sentence and the conviction that

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Mr Elle received,

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we will be pursuing recovery of our own original payment of £30,000.

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This well-respected fashion entrepreneur and businessmen had

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paid a high price for his attempted fraud.

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I think when Mr Elle reflects on this,

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he will obviously bitterly regret his actions.

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And the shame that he's brought on himself,

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his family and indeed his respected business.

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Still to come, a fisherman is caught hook,

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line and sinker after faking a burglary.

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We challenged the customer over that and he admitted that the item

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actually in the photograph wasn't stolen.

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Whether you've got a soft spot for cute kitties or a love for

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pedigree dogs, pet insurance offers owners protection should their furry friends

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need help. It's one of those policies you hope you'll never need,

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but it's also one that's all too easy to let slip.

0:22:590:23:02

Unfortunately, there are some owners out there who,

0:23:020:23:04

in the event they find themselves without valid cover,

0:23:040:23:08

will do almost anything to get their hands on a pay-out.

0:23:080:23:13

Puppies are adorable.

0:23:130:23:15

But these cute canines are a huge responsibility and incredibly

0:23:150:23:18

vulnerable. So, when a dog owner called to report a tragic accident,

0:23:180:23:23

Simon Wheeler's team were on hand to deal with the call.

0:23:230:23:28

This claim concerns a very young Pomeranian puppy.

0:23:280:23:31

A very, very sad case.

0:23:310:23:33

The owners were moving house.

0:23:330:23:35

In the evening, sadly,

0:23:350:23:37

the policyholder's sister trod on the puppy and killed it.

0:23:370:23:41

A horrible accident.

0:23:410:23:43

The claimant had bought the puppy from a breeder and he'd come with

0:23:430:23:47

a free 28-day period of insurance cover.

0:23:470:23:50

The first time we heard from the policyholder was a telephone call

0:23:500:23:55

just to determine when the temporary period of insurance ran out.

0:23:550:23:58

So, she'd elected not to continue that into a full annual policy.

0:23:580:24:02

So, the date was obviously important to her,

0:24:020:24:05

in terms of when the accident happened.

0:24:050:24:09

The purchase price of the puppy was £1,500.

0:24:090:24:11

A sizeable sum.

0:24:110:24:13

And without a valid policy,

0:24:130:24:15

the claimant wouldn't receive a penny back.

0:24:150:24:17

And it wouldn't be long before the claims team would hear from her again.

0:24:340:24:37

That very same day,

0:24:370:24:39

we then had another conversation with the policyholder.

0:24:390:24:42

And she called up to advise us that the puppy had died.

0:24:420:24:46

The 15th. Just one day before the policy was due to expire.

0:24:590:25:04

A fact she had suspiciously checked just hours earlier.

0:25:040:25:09

The claimant appeared to be too distraught to continue the call

0:25:090:25:12

and passed the phone to her daughter.

0:25:120:25:14

Between the claimant and her daughter,

0:25:440:25:47

we have established that the puppy died the day they were moving house.

0:25:470:25:52

But examining the veterinary records

0:25:520:25:54

gave Simon's team serious cause for concern.

0:25:540:25:57

I'm looking at the veterinary history,

0:25:570:26:00

the date that the puppy was killed was actually different to the date

0:26:000:26:05

the policyholder had suggested.

0:26:050:26:08

Rather than the 15th of December,

0:26:080:26:10

with the policy expiring on the 16th,

0:26:100:26:12

the date that the vet had recorded was actually the 17th.

0:26:120:26:16

So, the claim wasn't covered.

0:26:160:26:19

With the claimant's cover expiring on the 16th,

0:26:190:26:22

this information was put to her.

0:26:220:26:24

So, once again,

0:26:440:26:45

it seemed to be the claimant's daughter who was in charge of dealing with

0:26:450:26:49

the puppy's untimely death.

0:26:490:26:50

The policyholder received the notice from us that we declined

0:26:500:26:53

the claim because the incident occurred outside the period of cover,

0:26:530:26:58

as detailed in the veterinary notes.

0:26:580:27:00

The policyholder then challenged the veterinary history.

0:27:000:27:04

Despite the contradicting evidence,

0:27:040:27:06

the claimant was sticking to her story.

0:27:060:27:08

She's now blaming the discrepancy on her daughter's error.

0:27:320:27:35

And despite the claimant's increasing irritation,

0:27:350:27:38

the claims handler calmly relays the facts.

0:27:380:27:41

The claimant was starting to make a real dog's dinner of her story.

0:28:000:28:03

Furthermore, on listening to the calls,

0:28:030:28:06

the policyholder had been insistent that the puppy had been trodden on

0:28:060:28:09

on the day that they moved house.

0:28:090:28:11

And that date was the 15th of December.

0:28:110:28:13

When we went back to the policyholder

0:28:130:28:15

after we'd done our investigations,

0:28:150:28:17

she confirmed that actually the date of moving was the 17th

0:28:170:28:20

and the puppy had been killed on the 17th.

0:28:200:28:22

CLAIMANT SIGHS

0:28:370:28:39

A telling sigh. The claimant has just dropped herself right in it.

0:28:390:28:44

The policy expired on the 16th of December and we've already

0:28:440:28:48

established that the puppy's death and their house move occurred on the same day,

0:28:480:28:52

which she's just admitted to being the 17th of December.

0:28:520:28:55

Crucially, a day after the cover had ended.

0:28:550:28:59

Having had a situation where

0:28:590:29:01

the policyholder had tried to move the date,

0:29:010:29:04

to bring the date into the period of cover,

0:29:040:29:06

to have the purchase price covered,

0:29:060:29:09

it was yet more of an indication that she was trying to twist and

0:29:090:29:12

manipulate the cover to suit her needs.

0:29:120:29:16

Despite this whole dispute centring around when the puppy had his fatal

0:29:160:29:21

accident, the claimant decides that dates are suddenly unimportant.

0:29:210:29:25

Again, she was trying to manipulate

0:29:390:29:41

the timing of the puppy's death to fall inside the period of cover.

0:29:410:29:45

So, she's insistent and desperate and nothing was too much effort for her.

0:29:450:29:48

The claimant is clearly frustrated,

0:29:480:29:51

but the simple fact is her policy expired on the 16th of December and

0:29:510:29:55

she did not have valid cover.

0:29:550:29:58

But she's refusing to back down.

0:29:580:30:00

While the claimant continued to pass the buck,

0:30:330:30:35

the evidence was overwhelming.

0:30:350:30:38

The rejection of the claim stood and no money was paid out,

0:30:380:30:42

although this type of lengthy investigation

0:30:420:30:45

still does cost insurers.

0:30:450:30:46

It's tedious and it's time-consuming for all parties.

0:30:460:30:51

That adds a huge administrative burden into the process for us.

0:30:510:30:56

That administrative burden comes with a cost.

0:30:560:30:58

That cost, unfortunately, gets loaded into premiums.

0:30:580:31:01

This case proves that anyone who tries to pull one over on pet insurers is

0:31:010:31:05

going to have a rough day.

0:31:050:31:08

For people who try to manipulate dates or adjust things to suit their

0:31:080:31:11

own ends, it's usually very easy to see through it.

0:31:110:31:15

It doesn't take much effort to really pick under the skin of

0:31:150:31:18

situations that don't appear to be as they should be.

0:31:180:31:22

When it comes to making an insurance claim, there's no such thing as a

0:31:270:31:30

little white lie.

0:31:300:31:32

If you've been involved in a genuine accident, then exaggerating or

0:31:320:31:36

fabricating any damages and injuries to get a bigger pay-out is fraud.

0:31:360:31:40

And it can land those who try it in very hot water.

0:31:400:31:44

Transport companies are often victim to this type of opportunistic fraud

0:31:440:31:47

as there's a misconception they're a soft touch.

0:31:470:31:51

But this couldn't be further from the truth.

0:31:510:31:56

There are thousands of buses operating on UK roads.

0:31:560:31:59

These mechanical beasts are hard to miss.

0:31:590:32:02

Sometimes, literally.

0:32:020:32:05

Lee Ingram knows all about how motorists can get tangled up with

0:32:050:32:08

these oversize vehicles.

0:32:080:32:10

He was asked to look over one claim which seemed to be at the minor end

0:32:100:32:14

of the accident scale.

0:32:140:32:16

The actual accident circumstances in this case were

0:32:160:32:19

that a bus was overtaking a stationary line of traffic on its right.

0:32:190:32:22

It's gone ahead to do a left-hand turn into a side road and as it's done so,

0:32:220:32:26

the rear tail of the bus has swung out and pressed up against

0:32:260:32:31

the stationary car. The bus driver didn't actually know an incident had occurred.

0:32:310:32:35

It wasn't until a short while after,

0:32:350:32:37

when the car driver followed him down the road

0:32:370:32:40

and let him know that the accident happened, that he was aware of it.

0:32:400:32:43

A seemingly minor accident,

0:32:430:32:46

but the occupants of the car submitted damages and personal injury claims

0:32:460:32:49

totalling over £8,000,

0:32:490:32:52

which prompted Lee's team to re-examine the circumstances of the incident.

0:32:520:32:56

When we reviewed the accounts given by both of the claimants,

0:32:560:33:00

we found a number of inconsistencies in their statements.

0:33:000:33:03

Both of the claimants in this incident are alleging that they were jolted forwards

0:33:030:33:07

and backwards in their vehicle when the collision has occurred.

0:33:070:33:12

One of them's claiming that they were moving at a slow speed.

0:33:120:33:14

The other one said that they were moving at a moderate speed.

0:33:140:33:17

But the key factor there is that they both allege that the vehicle

0:33:170:33:20

was moving at the time that the bus struck them.

0:33:200:33:24

A strange account,

0:33:240:33:26

as the initial report had stated that the car was stationary during the incident.

0:33:260:33:31

But it would be the personal injury claims that would raise serious

0:33:310:33:34

-suspicions.

-The driver of the car has submitted a claim for

0:33:340:33:37

soft tissue injuries to his neck and back.

0:33:370:33:41

He's also alleging that he's got a fear of travel after this

0:33:410:33:45

seemingly low-speed impact.

0:33:450:33:47

He's also put in a claim for care and domestic assistance.

0:33:470:33:51

So, cooking, cleaning, childcare.

0:33:510:33:55

We do see these claims from time to time and the key really is to look

0:33:550:33:58

at the injuries sustained and think, "Is that reasonable?"

0:33:580:34:01

But you're also looking, in this case, to see who has actually

0:34:010:34:04

provided that care.

0:34:040:34:06

Given the extent of the claimant's alleged injuries and

0:34:060:34:09

the psychological effect of the accident,

0:34:090:34:11

you'd suspect a team of highly trained medical experts, wouldn't you?

0:34:110:34:15

He's alleging that the person who's given this care was his wife.

0:34:150:34:20

Now, she submitted in her claim that she also cannot do these very things

0:34:200:34:25

that he's alleging she assisted him with.

0:34:250:34:28

These two clearly need to communicate more often.

0:34:280:34:32

Sounds like the blind leading the blind.

0:34:320:34:35

And it wasn't just the claimant's personal injuries

0:34:350:34:37

Lee suspected were hugely exaggerated.

0:34:370:34:40

After an accident, we will often inspect a vehicle involved in a collision with one of our buses.

0:34:400:34:45

Part of that inspection is to take photos of the vehicle.

0:34:450:34:49

We saw photographs come back and they showed some minor

0:34:490:34:52

scuffing to the door in a sort of brushing motion,

0:34:520:34:55

and we'd also lost the back of the wing mirror off the car.

0:34:550:34:59

Very indicative of a minor impact,

0:34:590:35:02

rather than actually a dent

0:35:020:35:04

which you would expect from a side-on collision.

0:35:040:35:07

With the claimant's version of events suggesting a violent shunt had taken place,

0:35:070:35:13

it was time to check the bus CCTV to see what had actually occurred.

0:35:130:35:18

This footage clearly shows...

0:35:180:35:21

I mean, this chap and his wife have both said they were thrown forwards

0:35:210:35:25

and backwards. Take a look at that.

0:35:250:35:26

The car doesn't even move.

0:35:260:35:28

So, they haven't been tossed around

0:35:280:35:30

like an old pair of socks in a tumble dryer - as alleged.

0:35:300:35:35

We're talking about a push against a wing mirror on a car.

0:35:350:35:37

You push a wing mirror and it just folds.

0:35:370:35:40

No way. No way is that car moving from hitting that wing mirror.

0:35:400:35:43

Hardly the automotive carnage the claimants had suggested.

0:35:450:35:48

When we actually looked into this claim and investigated it

0:35:480:35:50

thoroughly, looking at the CCTV footage,

0:35:500:35:54

it soon became apparent that this was a very low-speed impact.

0:35:540:35:58

We couldn't really see how anyone

0:35:580:36:02

could have sustained any movement within this vehicle

0:36:020:36:04

following on from this very innocuous collision, really.

0:36:040:36:09

And despite submitting a claim of over £8,000,

0:36:090:36:12

the driver of the car was prepared to settle it at the scene for quite a bit less.

0:36:120:36:16

The claimant had gone to our driver on the day and had said that

0:36:160:36:21

if you paid him £50, he would go away and not pursue the claim.

0:36:210:36:24

Lee and the claims team had seen more than enough to make a decision.

0:36:240:36:28

We refused to accept that this barely perceptible coming together

0:36:280:36:32

of vehicles could have caused

0:36:320:36:34

anything like the level of injuries or damages that were being claimed.

0:36:340:36:38

So, we refused to pay the claim,

0:36:380:36:40

leaving the claimants with either the option of issuing proceedings on

0:36:400:36:45

us, or dropping their claims.

0:36:450:36:47

Despite the overwhelming evidence against them,

0:36:470:36:49

the claimants decided to take the case to court -

0:36:490:36:53

a decision they would regret.

0:36:530:36:55

The judge just simply couldn't believe, when he'd seen the footage...

0:36:570:37:01

He saw there's no movement in this car.

0:37:010:37:04

It's quite obvious. So, it doesn't take the judge much to look at the footage and think,

0:37:040:37:08

"This is just not right."

0:37:080:37:10

So the judge has struck the claim out in its entirety,

0:37:100:37:13

with an award for our costs in full.

0:37:130:37:16

So, it's a very satisfactory outcome to a claim that, once we'd looked at

0:37:160:37:20

the footage, really had no chance of succeeding.

0:37:200:37:23

Despite his many years in the job,

0:37:230:37:25

cases like this one are still keeping Lee on his toes.

0:37:250:37:29

I still am surprised with

0:37:290:37:31

the ridiculous claims we do get in sometimes

0:37:310:37:34

and the barefaced cheek of some people and what they will go through

0:37:340:37:38

just to try and make some easy money.

0:37:380:37:41

Also, I'm always amazed that they still haven't cottoned on the level

0:37:410:37:44

of investigations and detail that we will look into

0:37:440:37:47

just to verify a claim.

0:37:470:37:49

These people should really wake up

0:37:490:37:50

before they consider submitting a claim to us.

0:37:500:37:54

Now, if you're unfortunate enough to have something stolen,

0:37:590:38:01

then so long as you're covered with an insurance policy,

0:38:010:38:04

it can be replaced. In the event of a theft,

0:38:040:38:07

insurance companies place a lot of trust in us being honest about what's been taken.

0:38:070:38:11

But sadly there are those who attempt to bend the truth and

0:38:110:38:15

think adding an item here or there won't really make a difference.

0:38:150:38:18

The truth is, it's no different to going out and stealing that item.

0:38:180:38:22

So, when insurers suspect this is happening,

0:38:220:38:24

they'll do everything within their power to identify the fraud

0:38:240:38:28

and stop it in its tracks.

0:38:280:38:31

Home insurers can protect everything

0:38:310:38:33

from the kitchen sink to the garden shed.

0:38:330:38:37

David Berry's team at Lloyds Banking Group received a call from a customer

0:38:370:38:41

who'd had a less secure part of his property targeted.

0:38:410:38:45

In April 2015,

0:38:450:38:47

he contacted us by phone and explained to us that the lean-to,

0:38:470:38:52

which runs alongside the side of his house, had been broken into.

0:38:520:38:55

We asked the customer what had been stolen at the time and he explained

0:38:570:39:02

to us that he didn't think that

0:39:020:39:03

the thieves had got fully into the lean-to

0:39:030:39:05

because it appeared that they had only taken items

0:39:050:39:08

that were quite close to the door.

0:39:080:39:10

Although it could have been worse,

0:39:100:39:12

the claimant reported that some expensive items had been taken.

0:39:120:39:16

A number of items were stolen.

0:39:160:39:18

There was a drill, which he wasn't actually that bothered about because

0:39:180:39:21

he was more concerned about the fact he was a keen fisherman and a number

0:39:210:39:25

of items that were clearly important to him had been stolen.

0:39:250:39:28

Those items had been acquired over a period of time and also some of them

0:39:280:39:31

were very, very recently purchased.

0:39:310:39:33

And in fact they were very expensive. He estimated that the

0:39:330:39:36

total value of the claim was in the region of £5,000.

0:39:360:39:39

As the name suggests,

0:39:390:39:40

lean-tos aren't usually the most solid or secure of structures and

0:39:400:39:45

are commonly filled with low-value things.

0:39:450:39:47

So, to be keeping five grand's worth of stuff in there was slightly odd.

0:39:470:39:52

When we asked the customer to provide us with fuller details

0:39:520:39:55

in terms of the description of the items,

0:39:550:39:57

together with any receipts he had

0:39:570:39:59

or details of where he bought the goods from,

0:39:590:40:02

we also suggested to him that he might have photographs of any of

0:40:020:40:06

these items that might also help us understand their value.

0:40:060:40:09

As requested, the claimant promptly supplied the claims team with photos

0:40:100:40:14

of the alleged stolen items.

0:40:140:40:16

But there was one small problem.

0:40:160:40:18

When we looked at the properties within the equipment, we identified

0:40:180:40:21

that one of them was taken around about 20 minutes before he

0:40:210:40:23

reported the claim to us.

0:40:230:40:25

And the second one though was around about an hour,

0:40:250:40:27

a little bit over an hour, AFTER the claim was reported to us

0:40:270:40:31

over the phone.

0:40:310:40:32

A puzzling discovery, which was put to the claimant.

0:40:320:40:35

When we asked the customer to tell us when he had taken these photographs,

0:40:370:40:41

he told us that they'd been taken over a period of time,

0:40:410:40:44

going back maybe as long as two years.

0:40:440:40:46

It was looking like the claimant had only managed to frame himself

0:40:470:40:52

for a potential fraud.

0:40:520:40:54

We challenged the customer over that and he admitted that whilst he had

0:40:540:40:57

had some items of equipment stolen,

0:40:570:41:00

the item actually in the photograph wasn't stolen.

0:41:000:41:03

But he had added it to the claim.

0:41:030:41:04

The claimant had come clean,

0:41:040:41:06

but this lone confession didn't mean he was off the hook.

0:41:060:41:10

We explained to him that as part of that claim was fraudulent,

0:41:100:41:14

he wasn't entitled under the policy

0:41:140:41:16

to any payment because it was now our right to cancel the policy

0:41:160:41:19

on the grounds of fraud.

0:41:190:41:20

So, the claimant wasn't going to receive a penny.

0:41:200:41:23

But that wasn't the end of the investigation.

0:41:230:41:26

We reported the matter to the Insurance Fraud Enforcement Department and when they

0:41:260:41:31

interviewed the customer, he explained to them that actually

0:41:310:41:34

nothing had been stolen from the shed.

0:41:340:41:37

This keen fisherman had been baited by the false idea that submitting a

0:41:370:41:41

fraudulant claim would pay off.

0:41:410:41:43

Previously, he'd told us that a number of items had been stolen,

0:41:430:41:46

valued at around £5,000.

0:41:460:41:49

So, it really was a surprise to us when he actually did admit to the

0:41:490:41:51

police that nothing at all was stolen.

0:41:510:41:53

Despite the claimant's blatant and planned attempt to swindle his

0:41:530:41:57

insurers, he narrowly avoided prosecution.

0:41:570:41:59

As a result of that interview,

0:41:590:42:01

and again because the customer was of previously good character,

0:42:010:42:04

the police were prepared to deal with the matter

0:42:040:42:07

by way of a police caution.

0:42:070:42:08

Ifed will investigate any suspected fraud

0:42:110:42:14

and for insurers,

0:42:140:42:15

having the boys in blue as an ally often proves invaluable.

0:42:150:42:20

Had we not reported the matter to the police,

0:42:200:42:23

it's very unlikely that we would've actually understood ultimately that

0:42:230:42:26

nothing at all was stolen.

0:42:260:42:28

Insurance companies are making it crystal clear that they are not soft

0:42:280:42:32

targets and there will be serious consequences if anyone tries to defraud them.

0:42:320:42:37

I honestly don't believe that customers sometimes realise the

0:42:370:42:41

repercussions of what can happen if they're caught committing insurance

0:42:410:42:45

fraud. Potentially,

0:42:450:42:46

it could mean that the matter is reported to the police,

0:42:460:42:49

which could lead to imprisonment or a suspended sentence.

0:42:490:42:51

Insurance fraud in this country costs all of us money.

0:42:560:42:59

But the days of no-questions-asked pay-outs are numbered.

0:42:590:43:03

Insurers are getting ever more sophisticated technology to identify,

0:43:030:43:07

track and prosecute fraudsters

0:43:070:43:09

and courts are using new powers to put these criminals behind bars.

0:43:090:43:14

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