Episode 3 Claimed and Shamed

Insurance fraud in the UK has hit epidemic levels.

It's costing us over £2 billion every year.

That's almost £6 million every day.

Deliberate crashes, bogus personal injuries, even phantom pets.

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

Every year, it's adding over £50 to your insurance bill.

But insurers are fighting back, exposing 15 fake claims every hour.

Armed with covert surveillance systems...

That's a subject out the vehicle.

..sophisticated data analysis techniques...

and a highly-skilled, dedicated police unit...

Police. Don't move. Stay where you are.

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

-Just don't lie to us.

All those conmen, scammers and cheats on the fiddle

are now caught in the act and Claimed and Shamed.

Coming up: How a mobile phone insurance claimant's just dialled it in.

We've seen more sophisticated frauds, I think it's fair to say.

The IFED team get prepped for an arrest...

We get vested up for all jobs.

You never know what's going to be behind the front door.

..and how one bus passenger takes the realms of exaggeration up a gear.

You can't get any further from the truth

than what actually happened in this incident.

These days, you're no-one if you don't have a smartphone.

With some models costing more than £700,

they've become a major target for insurance fraud.

Because they are small, they're portable, they're easily lost

and stolen, they're valuable, they're always being updated

and there's always a demand for them.

Would-be conman Mr Hussein thought he'd try it on with a smartphone

scam, but the insurers had his number.

He began by opening an insurance policy for an iPhone.

And another.

And another.

In all, he took out ten policies,

in one day, from the same insurer, Aviva.

Clearly, he wasn't putting much effort into covering his tracks.

Although he was keen to cash in

using the same receipt each time...

It was a claims-handler in our claims centre that made

the connection, identified that he presented the same documentation

in support of each of the claims, which was an invoice from eBay.

..and before long, submitted ten claims

adding up to an incredible seven grand.

With such a large amount at stake,

Aviva looked at the receipt in more detail.

We were able to establish that the transactions on eBay

had never been completed and

therefore the purchases never occurred.

It was clear to Aviva that a fraudster was at work,

but not a particularly good one.

They went back to the claims and noticed something else.

-The first names were all different.

-Luke, Jason, Albert, Jack.

But Mr Hussein couldn't be bothered

to come up with different fake surnames.

We've seen more sophisticated frauds, I think it's fair to say.

His sheer laziness meant the fraud was easily uncovered.

What unravelled from Mr Hussein was the fact that he was using

bogus names and addresses for the same items,

lost in the same circumstances,

and providing the same documentation, using the same bank account.

With such strong evidence, the case was passed to the authorities.

Mr Hussein was arrested and charged with ten counts of fraud,

and he received a six week custodial sentence

and 100 hours community service.

We thought it was a proportionate outcome, that he deserved.

The case with Mr Hussein is sadly a common one.

Opportunistic fraudsters cost the industry £2 billion a year.

But if you thought lying over the telephone was child's play,

you'd be wrong, as Sally Griffiths and her crack team

of psychological claims-handlers know only too well.

It's actually very difficult for a person to lie over the telephone,

and people...of course, we have the advantage because people think

it's easier than it is in a face-to-face situation.

People are more brazen and they try it on, perhaps, a little bit more

over the phone than if somebody was sitting face-to-face with them.

But surely an insurance scammer would know

if they were being interrogated over the phone?

Well, that's the beauty of this technique.

What seems like a friendly chat to you and I could really be

an in-depth investigation into the truth behind your claim.

We use a combination of psychology, conversation management

and a little bit of cognitive interviewing skills, as well.

Our investigators have intensive training in order to pick up

any signs of deceptive behaviour over the telephone.

In other words, the team at VFM Services can work out

by the way you talk if you're lying,

just by listening to the way you describe your claim.

It's really interesting how much detail a person can go into

if what's happened to them is genuine, but a fraudster really

struggles with this, so we're really listening to see how much detail

they can give us confidently.

By studying trends in insurance fraud, Sally's teams have

been able to pinpoint the profile of the average fraudster.

And you might be surprised at the results.

We've actually done quite a lot of research into this,

and what we've found is the average fraudster is very typically

an opportunist, someone who doesn't consider themselves to be

a criminal, and someone who is just perhaps an ordinary person.

Doesn't think there's anything wrong with it at all.

But it's this cavalier attitude which is ultimately

an insurance cheat's downfall.

Their voice can give away so much, you can detect an awful lot

of nervousness and hesitation in a voice.

Once the fraudster realises that it's not so easy, we find that

customers tend to withdraw their claims rather than carry on.

And when it comes to the success of these techniques,

the figures speak for themselves.

Our fraud detection techniques have had a really big

impact on the industry. In the last nine years,

we've saved over £58 million for the industry as a whole.

Last year, 40 percent of the customers that we spoke to

actually chose to walk away from their claims, or had their claims

repudiated because of the techniques that we were using.

Still to come, a crash for cash gang get dramatic.

A person ran down the bus and head-butted the windscreen of it.

Totally over the top.

And how a shaggy dog story was quickly sniffed out.

The policyholder suggested she'd reported the loss to the police,

but there was no police reference number.

Crash for cash is an insurer's worst nightmare.

It's a scam used by criminal gangs to collect huge insurance pay-outs.

Whether they damage the cars themselves, or target

innocent drivers in deliberate road crashes,

the gangs don't care who they rip off, or who gets hurt.

When a bus travelling at low speed crashed on a quiet route

in Sheffield, it was seen as an accident

and nothing out of the ordinary.

After the crash, a report was filed by the driver.

Simon Robertson is from First Group, the company that owns the bus.

Following the accident, we ask our drivers, all of our drivers,

to report through to our first response unit.

The driver did so on this occasion and the details were taken,

and a lot of it looked sort of fairly innocent, innocuous and normal.

But then something happened which turned the case on its head.

The police received a tip-off alleging fraud on a massive scale.

We were getting in calls from an anonymous male

saying that this accident has been staged,

and there were going to be a lot of fraudulent claims submitted,

and they were going to defraud the insurance companies.

They went back to the report and immediately noticed some discrepancies.

The bus would generally have had about six people on it,

on that journey at that time of day.

But when the accident occurred, the bus was packed.

As predicted, large numbers of claims started to roll in.

At the time of the accident, there were 34 people on the bus

and we received claims from 29.

In such an accident, where the collision occurred

at such a low speed, there might be no claim at all, there might be some

minor damage to the vehicle that might need repairing.

Injury claims, probably not.

However, the claims were all remarkably similar

and alleged serious injuries.

The soft tissue injuries that were presented, or what you might term

a whiplash injury, didn't really correlate

with the force of the impact that had been reported to us.

But not everyone on the bus was in on the scam,

and their version of events was very different from what was being claimed.

The genuine passengers were saying to the police

that this was a minor crash and yet people were throwing themselves

about on the bus, one person ran down the bus

and head-butted the windscreen of it. Totally over the top.

Everything was pointing to fraud on a massive scale,

so the police began to dig deeper.

We started looking at the people on the bus and recognising them,

and because of the intelligence we'd got,

we started looking at a claims company, which was City Claims 4 U,

and we could see there were links between the claims company,

the bus driver and other people on the bus,

to the point where we executed a

warrant at the claims company's offices,

and there we found various documents,

lists of people's names, of people who'd been on the bus

and it was clear to us that some fraud was actually taking place.

The bus crash was just the tip of the iceberg.

We investigated further into the claims company

and found about 38 suspicious claims, or incidents,

that had been claimed for across the country.

Again and again, the same names cropped up.

Some of them were involved in various accidents, in various

capacities, and you think, "Are these people really this unlucky?"

And the answer is no. And in some instances,

we were able to prove that they weren't actually

in the locations that they claimed to be at the time of the accident.

The police suspected that the owners of City Claims 4 U

-were behind a huge web of fraud.

-They were an organised crime group.

Omar Gulzar and Shoaib Nawaz were the centre of it.

Omar Gulzar, in particular, attracted the attention of the police.

He was a very controlling, domineering character.

Many people were afraid of him and he used that fear

to manipulate them for his own gain.

Perhaps the most disturbing element of the scam

was the involvement of the bus driver.

He'd been paid £500 by the gang to make the accident seem legitimate.

Adam Herbert was a poor soul, really. He's ended up being a victim himself, if you like.

He'd been bullied and frightened and backed into a corner,

for whatever reason, where he felt, he would say, that he had no option

but to go through with it. He could have come to the police and said,

"Look, I'm being forced to do this, can you help me?" And we would have been able to help him.

Hard facts were needed to build the case,

so First Group examined the vehicles involved.

There was pretty minor damage suffered by the bus in this accident.

We've got photos showing minor cracks at the front of the bus.

The other vehicle was reported as having suffered minor damage at the time.

However, when we were sent photographs later on, they showed

really quite extensive damage to the back of the other vehicle.

It didn't add up, so they called in a professional.

The forensic engineer reported back that the damage clearly

could not have been sustained in the accident, and it looked to him

as if it had clearly been done elsewhere, at another time,

perhaps involved in other accidents or hit with a sledgehammer a number of times.

This additional evidence made us more suspicious.

The investigation revealed the breathtaking scale of Omar and Shoaib's crimes.

We believe these fraudsters had been arranging these accidents

for at least six months during the first part of 2011,

and they had as many as 56 accidents.

After a thorough investigation, the case came to court.

The judge identified this as a highly-organised criminal gang

that the public needed protection from. So Mohammed Omar Gulzar,

he was the organiser. He got sentenced to 4.5 years imprisonment.

Shoaib Nawaz was his kind of deputy. He was imprisoned for 3.5 years.

Adam Herbert was also punished for his part in the fraud.

The bus driver in this case got a 20 month prison sentence for the sake of £500.

He should have known better. He took a terrible risk

in risking his own life, possibly, and the passengers on the bus.

He's been caught, he's been prosecuted,

he has a criminal record. A high price to pay.

Gulzar and Nawaz tried to claim £500,000 in fake accidents,

but failed and collectively were put behind bars...

for eight years.

The Insurance Fraud Enforcement Department, or IFED for short,

is an insurance scammer's worst nightmare.

There is a dedicated, 40-strong unit

that work 24/7, hunting down insurance fraudsters.

The team was set up over two years ago to crack down on insurance crime in the UK.

Is there anything here that shouldn't be here?

That we're going to find?

In that time, it's made over 450 arrests,

and seen around 200 prosecutions.

If it's a fraud, it's in insurance, then it may well come to

IFED's attention and IFED will take the necessary action.

Police officers. Can you come to the door, please?

It's 7 o'clock in the morning and Detective Constable Kate Sibley

is up north, preparing for an early morning raid.

We get vested up for all jobs. It's just obviously safety.

Mandatory. You never know what's going to be behind the front door.

Big knives, etc. I'm not saying the chap we are after today

has got knives or anything, but we want to be on the safe side.

Arriving at the suspect's house before sunrise means the team

have a head start on any individual they're investigating.

I enjoy coming out and knocking on people's doors,

if I'm honest with you. And finding the evidence to prosecute.

The office-bound side of it isn't quite so exciting,

but it's all part and parcel of the job, so it has to be done to build the case.

But I do enjoy the early starts and the knocking on the doors.

Along with her colleague, DS Mark Forster,

they're on their way to arrest a suspect,

who they believe has been involved in a fraudulent insurance claim.

The job today's in relation to a claim that's been

put in for personal injury and damages,

saying that the local authority were at fault and negligent.

Kate's investigations have led her to an address thought to be

the suspect's main residence.

But locating a property in the dark is always tricky.

They're just sort of all tucked away.

The address we are going to, they're all tucked away behind new build houses.

-In here?

-Yeah. Um...

So it's a little bit difficult to find. It's in these...

-These ones here?

-Yeah, these ones here.

Just a minute.

Moments later, Kate and the team arrive at the house,

but concerned the suspect may make a run for it,

they ask the local police to cover all exits.

Just want to go round the back?

Morning. City of London Police.

Is ... about? Have you got his address?

Have you got a phone number for him? Can I have it, please?

It's alleged the suspect no longer lives at the address,

but the occupant does have a contact number for him, so Mark gives him a call.

It's Detective Sergeant Mark Forster from the City of London Police here.

But he doesn't answer and Mark has to leave a message.

We need to interview you, as a matter of urgency,

in relation to a matter we're investigating.

Can you please give me a call back?

It means the IFED team have lost the element of surprise,

and run the risk of losing evidence.

It's in your interest to get back to me as soon as possible.

Yep.

-All we can do is wait.

-Mm.

We can only do what we can do. But we'll get hold of him somehow.

Whether it's he's invited in or we eventually find an address for him

and we go and knock on the door. So if he doesn't come back to us,

then we'll just have to go back and do a lot more digging, find out his latest address and then...

come back. I won't give up.

But Kate is confident they will get their man.

It's just going to be a waiting game to see if he contacts us.

He can't hide.

We will get you. One way or another.

Later, Kate closes the net on her suspect.

Oh, yes, I am. Where are you?

Every year, thousands of pets go missing in the UK.

For the owners, the loss can be unbearable.

When people lose a dog, people are desperately upset.

It's not like where you've got a motor car with a dent in the wing

and you just get the dent knocked out. It's part of your family.

In May 2010, one family was left devastated

when their beloved pooch ran off during a riverside walk.

Having lost all hope of finding the dog, its owners submitted

a claim to Agria Pet Insurance, explaining what had happened.

The letter that came in with a claim form talked about how the family

and the children, you know, searched frantically for the animal.

So very, very emotive in terms of the claim form information.

Looked high and low for the animal for a few hours that afternoon.

Had family and friends out to look after it, look for it as well.

And then she'd also gone back to the spot for a number of weeks

afterwards, left treats out, but to no avail.

It was a tragic loss. Although nothing could replace the beloved family pet,

the insurers had to assess the missing mutt's worth.

It was an eight-month old, a smooth-haired miniature dachshund.

To all intents and purposes, a young, healthy animal.

If you bought one again, you could range in price

probably from 500 maybe to £1,000.

All that was left to do was check the paperwork,

which is when the story started to look decidedly shaggy.

The first point where we had doubts was that the receipt

that came in from the breeder, or was submitted on behalf of the breeder,

the handwriting was very, very similar to the claim form.

This gave the insurers "paws" for thought

and they double-checked the other details.

The policyholder suggested she'd reported the loss to the police,

but there was no police reference number.

There were one or two other things as well, for example,

the dog had never seen a vet in eight months,

at all, even supposedly with the breeder or with the owner.

Now most dogs see a vet as a matter of course.

There was more than a whiff of suspicion about the claim,

so Agria requested photographic evidence of the owner's beloved pet.

We had seven photographs submitted. Again, more cause for doubt

because very evidently in the seven photographs,

there were three different dogs there.

To the untrained eye, they all look the same.

But are you ready for a bit of doggy spot the difference?

Number one: The ages of the dogs are all different.

Number two: The eyebrow features are different.

And number three: The colouring on the nose.

And after some sniffing around, Agria investigators

quickly turned up the source of one of the pictures.

We looked around the internet, a cursory search on Google images found

the animal that had been used in the poster, and that was on a training website.

And one of the other photographs was from an American website for

puppies for sale. It looks like she went on to the internet to find

images of dachshunds. Certainly, to pull the poster together,

an image of a dachshund was used,

rather than one of the photographs she had of a dachshund with a family.

Meanwhile, the owner finally produced a police reference number,

but made a howler here.

However, in chasing that up, it appeared that the date

that the animal was reported missing was three days

before the actual date on the claim form.

By now, the claim was looking decidedly shaky.

We had sufficient evidence to give us sufficient confidence

that what was being claimed for was not right,

was fraudulent and wasn't a bona fide claim.

The policyholder had made a real dog's dinner of the claim,

with the wrong date, handwriting and pictures,

she'd well and truly put her foot in it, and Agria rejected it.

The double-decker is a stalwart of our streets.

Always there, any time of the day or night, to take us from A to B.

First Group transport over 2 million passengers every day,

so when a report of an accident came in to Lee Ingram, it wasn't that unusual.

-Yet.

-The lady's claimed that the bus had stopped suddenly,

causing her to fall down the stairwell from the upper deck.

She has then injured her back and

found herself lying prone on the floor.

Her nephew has then fallen down the stairs after her,

and fallen on top of her, basically.

Falling from such a height down steep stairs on a moving bus

can cause serious injuries.

Falling down from the top of the stairs to the bottom on a bus,

you could quite conceivably break limbs or suffer a nasty head injury.

So when a claim came in for a series of muscular injuries,

the case was still not that unusual.

The lady claimed that she sustained soft tissue,

probably muscular, injuries to her back and leg,

and also she was having problems sleeping.

Nine months on, she was still having difficulties with these injuries.

Her nephew also claimed that he had sustained a whiplash injury

when his neck was jerked backwards.

What did appear strange was that the woman

and her 19-year-old nephew never reported it to the bus driver.

But, as the saying goes, pride comes before a fall.

Sometimes, if people are injured on buses, they are embarrassed,

you can be a bit ashamed if you fall

over on a bus and everyone is sort of looking at you,

and you won't always stop and speak to the driver,

you will sometimes just get off the bus,

but CCTV will show whether it happened or not.

The camera never lies, so Lee took to the multiple on-board

CCTV cameras to see exactly what happened.

Now prepare yourself, this is pretty shocking.

When reviewing the footage, I saw the lady and her nephew board the bus.

They walk quite comfortably up the stairs,

they sit at the front of the bus. Some time passes.

They press the bell. They walk down the stairs.

The nephew walks down first and waits at the bottom. The bus stops.

He gets off the bus, closely followed by his aunt.

They both exit with no event having happened whatsoever.

Uh, sorry, can I see that again? I think I missed something.

I watched the footage from the beginning to the end,

and there was nothing on that footage that even closely resembled

what this lady was describing.

No, you didn't miss it. The woman never fell down the stairs.

And, as the footage shows, she walked off the bus completely unscathed.

You can't get any further from the truth than what actually happened in this incident.

Nothing has happened throughout the whole journey to resemble

anything like she is describing.

Most insurance fraud is an opportunistic

exaggeration of an event that did happen,

but this woman took it to a whole new level.

Most instances, you'll see someone will exaggerate the circumstances

and say something had happened when there were slight variations.

It's extremely rare that we actually get a claim in where nothing happened at all.

It's actually quite shocking as to how anyone would make such

a blatant attempt to defraud a company.

The story is totally and utterly fabricated.

It's just shocking that someone would even try this.

First Group rejected the claim.

The IFED team are on the hunt for a man involved

in an alleged personal injury insurance fraud.

They'd hoped that by getting to his address before daylight,

they'd get their man and any evidence.

Just want to go round the back?

But they've come to a dead end.

Morning. City of London police. Is ... about?

Have you got a phone number for him?

Forced to leave a message on his phone...

We need to interview you as a matter of urgency...

All they can do is wait.

We will get you. One way or another.

After following some leads, they think they've finally found him.

At first, it appears that no-one is at home.

-Do you want to see it round the back?

-But Kate's persistence pays off

when a friend of the suspect opens the door.

Yeah. City of London Police. Looking for ...

Right, is he at work?

-Can we come in?

-Although the occupant claims the suspect doesn't live here,

Kate and Mark want to check for themselves.

Well, there's a lot of male clothes in here.

With no leads from the homeowner, it's another dead end for the IFED team.

No. Definitely not up there.

The main bedroom's got loads of male clothes in it.

-There's a bedroom there as well.

-Yeah.

-The front room can be used as a bedroom.

-Yeah.

-But that was...

Yeah, there was male clothes in the top bedroom.

Kate heads back to the car

and finally receives the call she's been waiting for.

Oh, yes, I am. Where are you?

All right, OK, I'll speak to you in half an hour. He's just phoned me.

-Has he?

-Yeah.

-Oh.

-"I believe you're looking for me." Yes. "What's it regarding?

Give me half an hour, I'll phone you back and meet you." Where are you? "I'm not telling you that, am I?"

Kate and Mark think the suspect is buying time

so he can get legal advice before coming into the station.

He's going to want to meet at the nick, I would hazard a guess,

but he's going to get lifted, isn't he?

He's probably going to get a brief sorted, isn't he?

-Yeah.

-And he'll call back, or he's brief will call back.

So it's very frustrating, but when you've got somebody on the other end

of the phone and the number hasn't shown up he's calling from,

it's a bit difficult to sort of say, "Right, you're here, we'll come and get you",

because he won't tell us. That's the game we play.

It's been a tough morning but the best things come to those that wait,

and finally Kate gets some good news.

The suspect's solicitor has just phoned me and our suspect is making

his way to the police station as we speak,

so once he arrives we'll arrest him,

get him booked into custody and then we'll interview him.

But he is having a solicitor, so he is on his way.

So we've got our man, eventually.

The case is still under investigation.