Episode 10 Claimed and Shamed

'Insurance fraud in the UK is reaching epidemic levels

'and it's costing us billions of pounds a year.'

'Deliberate crashes, bogus personal-injury claims -

'even fake deaths.'

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

'And, every year, it's adding up to £50 to your insurance bill.'

'Insurers are fighting back.'

'Armed with covert surveillance systems,...'

CCTV cameras are the best tool we've got in our fight against fraud.

'..sophisticated data-analysis techniques...'

This is connected to a bank account and a second mobile-phone number.

'..and a newly-formed dedicated police unit,...'

Police! Step back!

'..they're catching the criminals red-handed.'

'All those conmen, scammers, cheats on the fiddle -

'now they're caught in the act

'and claimed and shamed.'

'Today the Insurance Fraud Enforcement Department

'is raiding two houses in a hunt for suspects.'

Police!

'An incident on a roundabout

'illustrates that the roads are far from safe.'

We believe it was an induced crash and the two cars were in collusion.

'And one claimer appears to have made a surprising recovery,

'judging by these pictures.'

'Insurers are increasingly using surveillance

'to combat insurance fraud,

'which makes even the most meticulous of deceptions

'unlikely to succeed,

'as this next case shows.'

'A motorway collision resulted in a victim's vehicle

'being forced against the central reservation.'

'Due to the extent of his injuries,

'the victim subsequently submitted a claim for compensation.'

'Geoff Owen is a consultant with law firm Greenwoods,

'which has an anti-fraud group that worked on the case.'

He had injuries to his neck,

his shoulder and his arms,

as a result of which, he had loss of sensation in both of his arms.

He said he couldn't drive because, as well as the physical injury,

he also had a psychological aversion to travel.

'The claimant said that all this meant he could not return to work.'

When you have a claim which involves an inability to work or to travel,

it begins to escalate.

This claim reached the heady numbers of £500,000

and that's a claim which the insurers take very seriously indeed.

'As part of the claims process, he went for medical examinations

'to assess his injuries and the length of recovery.'

Early on, the doctor said he could return to work within two years.

He also went for psychiatric assessment

and the doctor there thought he could resume work in six months,

so it was very surprising when he hadn't returned to work

quite quickly after the accident.

'The growing claim and the fact that he hadn't returned to his job

'led them to investigate further.'

There were suspicions raised that the type of claim arising

was out of proportion to the injury that had been sustained.

'This gave the insurers serious misgivings,

'so they put the claimant under surveillance

'and brought in a team of specialist investigators.'

'The man who led the project has to remain anonymous

'so he can continue working in the field.'

'The first challenge was to track down the claimant.'

We were given three addresses - he was quite evasive initially -

and he lived in high-rise blocks of flats.

That is a difficulty because you have to ID the claimant first.

'They eventually pinpointed where he lived

'and started surveillance on the main door to the block of flats -

'the only way in or out - or so they thought.'

We placed him under a few periods of surveillance,

but he didn't come out at any time, which we thought was rather strange.

'The surveillance continued

'and eventually they made a breakthrough.'

It transpired that the claimant was first sighted

when he came out of a back, ground-floor lounge door,

which led out onto an enclosed patio

and then scaled a four-and-a-half foot wrought-iron railing fence.

That was his mode of access

every time he left the property and went back in.

You try and take an impartial view when you get on plot,

but when somebody jumps over a railing -

it was an unusual thing to do.

'Not only was he displaying athletic abilities

'that were inconsistent with the level of injury he was claiming for,

'but his behaviour implied that he suspected he was being observed.'

'The undercover filming continued

'and more revelations were to come.'

He suggested that he couldn't drive and we filmed him driving.

He said he had difficulty getting in and out of vehicles,

but the film we obtained of him

clearly showed that he didn't have difficulties accessing vehicles.

As the video footage carries on,

he continues to drive long distances and he starts to go shopping

and one day returns home with a huge weight of bottles of water.

For a man who wasn't supposed to use his arms,

particularly to carry weights, that was quite surprising.

'The video evidence was shot over a significant period of time

'and appeared to contradict the level of injury being claimed.'

As non-medical experts,

he didn't appear to be in any particular pain or discomfort.

He wasn't grimacing, he didn't have to stop.

'Eventually, the case went to court

'and the claimant argued for a substantial payout,

'but the insurers' video evidence questioned his version of events.'

He represented himself, didn't do very well -

he received £9,500,

which was for the genuine injury that he had sustained,

but the rest of his claim was disallowed by the judge.

'That meant he received only a tiny proportion

'of the huge amount that he originally demanded.'

It's difficult to know why claimants do this sort of thing.

It can only be driven by greed.

There's a feeling that there's a cash cow that they want to tap into.

What they have to realise is that insurers are becoming aware of this

and are doing their best to stop it.

'An insurer sniffs out a snide claim

'for a supposedly lost Rolex.'

If the claim was genuine, we would be able to pay her for the loss.

'And a van driver is apparently targeted by a suspected crash gang.'

I think pretty clearly, soon afterwards,

he knew there'd been a problem.

'In the fight against the growing problem of insurance fraud,

'an elite police squad have come together to form IFED -

'the Insurance Fraud Enforcement Department.'

Insurance fraud isn't a victimless crime -

£50 of the premium you pay each year

goes to the fraudsters.

We are tackling that problem.

'This dedicated team works tirelessly to bang up the conmen

'getting rich off other people's money.'

Police!

It's our intention to create a climate of fear for the fraudster.

There's every chance that an IFED detective may come knocking

to arrest them for insurance fraud.

Police! Stay where you are!

'By April 2012, after only six months of operating,

'they had already busted 80 fraudsters,

'adding up to £12 million of fraud under investigation.'

These people are criminals. These are nasty people.

They don't go out to work on a Monday like most people do.

Their work is submitting insurance-fraud claims.

'The Insurance Fraud Enforcement Department

'is investigating an alleged large-scale car-insurance fraud,

'involving multiple suspects and several locations.'

'DS Mark Forster is leading the investigation.'

He's travelling with his team to make a raid on the first address.'

We are going to execute search warrants

and hopefully make five arrests

in relation to setting up -

fraudulent setting up - of motor-trading policies.

They are doing it to get access to the motor insurers' database,

to therefore sell on insurance,

so they are targeting young drivers in London,

charging them £300, £400, £500 each

to then have their vehicles put on the motor insurers' database

which shows them as being insured, when in fact they are not.

'The team arrive at the property.'

'They hope to find four suspects,

'so the size of the operation means they have extensive back-up.'

-Police, open up!

-Let's see what he has got.

He's coming.

'The door is opened by one of the residents and they are in.'

Police!

Police! Police officers! Police! Police! Police!

Stay there for me, please.

Get some clothes on, please.

We'll get everyone downstairs and explain what is going on.

'Meanwhile, in a nearby neighbourhood,

'TI Alex Cooley is about to lead the raid on the second property.'

Moving into position now, a couple of people on the back door.

I will be going in the front door along with the support group,

these guys in uniform.

Come down, mate. Police. Come down now.

Now! Get down to the door or it's going in, mate!

Open up the door or it's going to be opened.

-It's taking too long.

-It's all right. Here he is.

'At the last minute, the man complies and opens the door.'

Got a warrant to search your premises.

'They enter the house and go through the rooms.'

Yes, we're from the City of London Police,

we have got a warrant from the magistrates

to search for any documentation relating to insurance fraud.

We're interested in motor-insurance fraud. That's why we are here.

We will aim to do things as quick as possible.

'Back at property one, Mark has the suspects gathered in the lounge.'

I'm arresting you on suspicion of conspiracy to defraud, OK?

And also on suspicion of money laundering, OK?

You do not have to say anything, but it may harm your defence

if you do not mention something which you later rely on in court.

Anything you do say may be given in evidence.

Yeah, we'll interview you.

Nothing inside your waistband.

'In all, four suspects are formally arrested, searched and handcuffed.'

'They are then taken from the house for further questioning

'at a local police station.'

'IFED suspects they are involved in fraudulently adding uninsured cars

'to the motor insurers' database.'

'But they will only be able to back that up if they find evidence

'from a thorough search of the house.'

You do get the impression

they don't cover their tracks as well as other fraudsters may do.

'One of the most dangerous forms of car-insurance fraud

'is the induced collision.'

'This is where gang members drive two cars in such a way

'as to cause an innocent driver to smash into them,

'giving the impression that they are to blame for the accident

'and therefore liable to pay out on their insurance.'

'It's known as "crash for cash" and it works like this.'

'First, the gang choose a victim.'

'Then they move their two cars into position in front of the target.'

'Gang car number one then slams on its brakes,

'gang car two reacts and brakes,

'resulting in a rear-end shunt from the victim.'

'Gang car one turns off at the next turning,

'pretending to be unaware of the cash.'

'Fleet vehicles are especially at risk -

'fraudsters need to ensure victims have insurance.'

'Peter Oakes is the Head of Fraud

'at a law firm that worked with a company targeted by one such gang.'

'He worked on one case which seemed to be a standard collision.'

The car was going round a roundabout,

it came to a halt because of the actions of another vehicle

and the Ocado van is alleged to have crashed into the claimant vehicle.

'The company was then contacted by the driver of the car,

'who submitted a substantial compensation claim.'

Three claims of personal injury, vehicle damage, credit hire,

storage charges - all of the usual things

that go with the personal-injury claims that are made,

in addition to the claimant's solicitors' fees.

If the claim had gone through and been successful,

it would have cost Ocado about £40,000.

'The claimant didn't realise

'that the company was using cutting-edge technology.'

The vans are fitted with cameras,

which record throughout the journey

on a half-hour loop.

Every time there is a vehicle incident,

the driver will report it to his manager

and that winds its way to our in-house insurance department,

who will look at the camera footage from that incident.

'The footage in this case

'was studied to see if it matched the claimant's version of events.'

'Instead it told a significantly different story.'

What it actually shows is the Ocado vehicle going onto a roundabout

and it's preceded by two vehicles,

a Vauxhall Zafira and Vauxhall Corsa.

The Zafira appears to indicate that he doesn't know where he's going.

He goes to leave the roundabout and then back on at the last minute,

apparently leaving the Corsa with nowhere to go.

The Corsa performs an emergency braking manoeuvre

and the Ocado vehicle is only just able to stop in time.

We believe it was an induced crash and the two cars were in collusion.

'The key thing the footage shows is that there is no collision.'

'Thanks to the driver's reactions, he managed to avoid a smash.'

'The evidence disproves the claimant's story

'and also appears to show there was an attempt at an induced collision.'

I don't know if the driver knew that he was a victim of crash for cash,

but you can hear the surprise in his voice.

He pulls over afterwards and exchanges details,

I think, pretty clearly soon afterwards,

he knew there had been a problem.

'With solid proof that there was no collision, the company took action.'

We wrote to the claimant's solicitors and said we wouldn't pay,

in our belief it was fraudulent in its entirety.

And, as is typical, we didn't hear from those solicitors again.

'Thanks to the video evidence,

'the claimant didn't get a payout for a collision that never happened

'and was left empty-handed.'

'Between 2010 and 2011,

'three quarters of a million house burglaries were reported in the UK

'and insurers received domestic and personal-theft claims

'totalling £415 million.'

'Whilst for most people, a burglary is traumatic event,

'others see it as a golden opportunity to make quick cash.'

'Paul Hubbard is Head of Counter Fraud at an insurance company

'which was landed with one such spurious claim.'

In this case, the customer submitted a claim to us for a burglary.

There were several high-value items, including a £2,500 Rolex watch.

'With such a high-value item listed on the claim form,

'the insurer needed to find out more.'

Our next step was to go and speak to her

and find out more detail from her about what had happened

and see if we could find some proof of ownership

that, if the claim was genuine,

we would be able to pay her for the loss that had occurred.

'When the investigator asked to see proof of ownership of the watch,

'things started to unravel for the claimant.'

He suggested perhaps she would have a photograph of the watch.

She said she did, but it had been wiped from her BlackBerry.

So she said that, while she no longer had a photograph of it,

she knew her friend did.

'When they received the photograph, almost two months later,

'forensic image analysis led to an intriguing development in the case.'

They looked at the photograph

and what they actually found was that the photograph had been taken

after the loss had happened.

So she was lying to us.

'Unbeknown to the claimant,

'hidden in the photo was information that proved they were lying.'

'The secret data told the insurer the exact time and date

'of when the photo was taken.'

'and it was taken a full 17 days

'after the watch was said to have been lost.'

Most of our customers are genuine customers,

but, on this occasion, this person got very greedy.

'Greedy and, it seems, unwilling to let the matter lie.'

Despite the evidence we presented,

we were surprised to find that she then decided to refer the matter

to the Financial Ombudsman,

she wasn't happy to accept that she'd got caught committing a fraud.

'But, unfortunately for the claimant,

'the Ombudsman wasn't falling for it either.'

All the details were sent to the Financial Ombudsman

who upheld the decision that we had made to turn down her claim.

'It would seem that, for fraudsters,

'Rolex watches present an irresistible opportunity.'

We see lots of claims for Rolex watches and most are genuine.

But actually there have been more Rolex watches stolen

and claimed for through insurance companies than have ever been made!

'The Insurance Fraud Enforcement Department is raiding two properties

'as part of an investigation into a suspected fraud

'involving an insurance database.'

'A gang is believed to be adding cars to the database,

'which shows them as being insured when they are not.'

'The aim of the raids is to arrest and question a group of suspects

'and find evidence relating to the alleged motor-insurance fraud

'and suspected money laundering.'

'The IFED team has arrested the main suspects in the first house.'

'Meanwhile, the raid on the second house is led by TI Alex Cooley.'

'The residents are brought down

'and Alex identifies the suspect he believes to be involved.'

I'm arresting you for fraud.

You don't have to say anything, but it may harm your defence

if you fail to mention something which you later rely on in court.

Anything you do say may be used in evidence.

'The IFED team needs to find documentary evidence

'to support their investigation into fraud and money laundering.'

'As they start the search for motor insurance and financial information,

'Alex gets the suspect to show him where he stores his cash.'

Yeah, just 1,000 cash.

-How much is there?

-£1,000.

-OK.

'Alex decides the suspect should be taken to the police station

'for further questioning and he's led away.'

'Back at the first house, the team led by DS Mark Forster

'is searching for evidence to support the investigation.'

We want mobile phones, computers, which I haven't seen many of.

Any data-storage devices -

erm, USB-type sticks and stuff like that.

And also documentation relating to any of the seven companies

that the motor-trade policies have been taken out in.

Any insurance documentation that relates to any of those policies

or any other policies we think might have been incepted fraudulently.

Just found a certificate of motor insurance.

Looks like it has been photocopied rather than printed off.

'A potentially crucial discovery is found inside the suspect's car.'

In the doorway, you have got "new vehicle quotation" -

basic price 91,

118 all in, with all the modifications, all the extras.

It looks like he's paid 10 grand in

and then maybe another £2,000 as a finance agreement.

Very nice - "on order".

'The documentation shows the suspect has on order

'a £118,000 top-of-the-range new car.'

'The potential expenditure is relevant to the investigation

'because IFED has the power to look at suspects' spending patterns

'and financial arrangements.'

'Back inside, Mark is on the hunt

'for information about the suspect's bank accounts.'

They have been arrested for money laundering

and we would like to start seeing where the money is going,

what money they have got.

If there is a large amount of money,

our financial investigators can put a restraining order on that money.

It is down to them to prove, basically,

that that money has been obtained by legitimate means.

'As well as the bank details,

'Mark also identifies an insurance document that could be relevant.'

Motor trade cover note.

Alliance is the insurance company.

That was incepted or operational from the 23rd July this year.

People into this fraud look at it as a safe way of making a lot of money.

It was pretty much unheard of of people being arrested

for this level of fraud

against insurance companies - until now obviously.

You do get the impression that they don't cover their tracks

as well as other fraudsters may do.

'Back at the second property, the search for evidence continues.'

'It's vital for the investigation that they find documentation

to support the case.'

'Suddenly, Alex makes what could be a significant discovery.'

A letter to do with some... collision.

Road-traffic collision.

Here we go. That's interesting, look.

We've got a crib sheet. Excellent.

We have got a map and a crib sheet here.

I have heard of these, I've never actually found one myself.

But... you will, occasionally, find a map

and a... an explanation of what to say.

So what I have here

is a map showing two cars colliding with each other and an explanation -

"I was driving out on the main road,

"the third-party driver pulled out from "give way"

"and hit me on the passenger side, middle and rear."

'Alex and his team have bagged everything up and are about to leave

'when one final key piece of evidence is identified.'

This document is one of a series,

which I found in a box on the suspect's wardrobe,

which does concern the motor-trade policy

with a company that we were interested in.

So, so far, so good. We have found what we came here for.

'At the first property, evidence gathering is also in full swing.'

'Mark checks inside a safe he has found in one of the bedrooms.'

Rings, chains.

'This find could be significant,

'as buying gold can be a way of laundering money.'

I'm pleased, we have everything we could have hoped to have found.

We have found two large amounts of cash in excess of £1,000,

a large amount of gold.

'The sizeable amount of evidence that IFED collects from the house

'needs further investigation,

'so they will be packing it up and taking it back to their HQ.'

'As the raids draw to a close,

'IFED has successfully tracked down and arrested all five suspects

'and collected a significant amount of evidence.'

The next stage is for IFED

to put together a case using what's been found.

The suspects remain on bail and the case is still under investigation.

But the level of research and preparation into a case like this

illustrates IFED's commitment to tackle insurance fraud.