Episode 4 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.

And 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 the subject out of 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.

Today - a staggering personal injury scam

that was fuelled by lies and greed.

Her claim had risen to approximately £740,000.

An IFED raid develops into a drug bust.

It's something I've not seen before in nine years of policing.

And the extraordinary lengths that a mother of three went to

in order to cash in.

She forged the signature of the doctor

and also made a stamp from the surgery to authenticate the policy.

It's a simple fact of life that accidents do happen.

But, thanks to insurance policies, in many cases, we are entitled

to compensation for these unforeseen mishaps.

Local councils see more than their fair share of personal injury claims.

But Haringey Council know better than most that

when it comes to compensation, some people are never satisfied.

In 2008, they received a complaint from local resident, Barbara Fari.

Mrs Fari claimed that she fell over

whilst she was walking with her granddaughter.

She claimed that she tripped and she fell and she hurt her knee

and she said she'd tripped and fallen on a broken paving stone.

With the level of wear and tear

that road and pavements are subjected to,

incidents like this are inevitable,

so Haringey Council began their usual procedure

for such a claim and launched an enquiry.

Homes for Haringey didn't dispute the fact that she had fallen,

that she had suffered injuries.

And the council, when it investigated that claim,

found that it had been negligent

in maintaining that section of pavement.

So we have a genuine claim for a fall that actually happened.

And the council have admitted negligence.

Sounds like a textbook case for compensation.

What could possibly go wrong?

Her initial claim was for damage to her knee.

The council made an offer,

which was approximately £7,500

on the basis that Homes for Haringey's assessment

of the injuries were that it would've resolved itself

within a three-to-six month timescale.

£7,500 for an injured knee seems fair enough.

But Barbara Fari didn't agree

and decided to take matters into her own hands.

She submitted her own medical expert opinion to say

she was severely incapacitated by the fall

and the injuries were likely to be ongoing and severe.

We sent Mrs Fari to our own medical experts,

who agreed that her injuries were substantial

and likely to be continuing

beyond the initial three to six months original prognosis.

In light of the revised assessment of her injuries,

Barbara Fari submitted a new claim for compensation.

It's fair to say that the amount she was asking for

isn't quite what the council were expecting.

Mrs Fari claimed that her quality of life had altered

so substantially that her claim had risen to approximately £740,000.

For those of you who aren't mathematically-minded,

that's almost 100 times the figure

that Barbara Fari was originally offered.

But how did she get to such an inflated amount?

She claimed her husband had to give up his work

to care for her 24 hours a day.

She claimed for additional care support beyond her family.

It was for out-of-pocket expenses for taxis,

for additional expenses

as a result of not being able to live her life normally,

as she claimed to have done before.

The level of care and assistance that Barbara Fari was claiming for

was so extensive that Haringey Council began to have serious doubts

about the legitimacy of her claim.

So they decided to investigate further.

We made a decision to put Mrs Fari under surveillance

to see if what she was claiming

was actually true in her day-to-day life.

It was felt that Mrs Fari thought that she was being followed.

And resorted to using crutches

and getting support from her family members.

However, when she felt like she wasn't being followed,

the crutches were dispensed with and she was able to walk normally,

including carrying heavy bags of shopping up and down a hill,

entering the house without difficulty.

So the surveillance activity in this case, we felt was,

not only was it justified,

it supported the Homes for Haringey's case against Mrs Fari.

With the video evidence clearly showing

that Barbara Fari's claims were untrue,

her case for compensation was falling down.

And, as Haringey Council's investigations continued,

they discovered the severity of her injuries weren't the only thing

that Mrs Fari had been less than truthful about.

Mrs Fari's original statements made no mention of the fact that

she had an existing condition of arthritis, which affected her knee.

Both her own medical expert

and Homes for Haringey's insurers' medical expert

agreed that they had both been misled by Mrs Fari

and revised their statements accordingly.

Barbara Fari's case was on dodgy ground

but she still had one last chance to set the record straight.

We presented the video surveillance to Mrs Fari and her solicitor

and invited her to revise her assessment of the £740,000 claim.

Mrs Fari declined that and so the case went to court.

So from an original offer of £7,500 for a legitimate claim,

Barbara Fari's greed and fraudulent actions

landed her in front of the judge in the High Court.

The judge made an assessment that her injuries were unlikely to continue beyond three months

and in his opinion

the claim should have amounted to no more than £1,500,

as opposed to the £740,000 that she eventually claimed.

In fact the judge was of the opinion that she wasn't entitled to claim anything.

But unfortunately for Mrs Fari, that was just the beginning.

After the judge had said that Mrs Fari had lied to the court and to him,

Mrs Fari and her husband were found guilty of contempt of court.

Mrs Fari received a three-month custodial prison sentence.

The judge awarded costs to be paid by Mrs Fari

to Homes For Haringey of £100,000.

It's hard to believe that what had begun as a genuine case for compensation

had spiralled into a landmark legal case

that sent a clear warning to anyone tempted to exaggerate a personal injury claim.

We're not an easy target.

We will investigate any and all cases that we think are made fraudulently

and we will always seek the heaviest penalty.

Still to come - surprising discoveries...

Just stumbled on something quite important.

It will have a big impact on the local community.

..and a summer holiday scam.

What set out to be a family holiday in Lanzarote

had turned into a nightmare for her.

Owning a pet can be an expensive business.

The good news is that a pet insurance premium

can cover unforeseen vet bills and even pay out in the event

that your furry friend is lost or passes away.

But inevitably, some people have seen these policies

as a means of pocketing a few quid.

In 2005, the insurance company Agria dealt with a policyholder

who, it would turn out, lost pets with staggering regularity.

The policyholder was a traveller who lived in Scotland

and part of the complication of the case

was that he had multiple addresses, so very difficult to pin him down,

very difficult to tie one address to another.

The first claims received from this policyholder

were for two St Bernard puppies.

They were worth £850 each and they'd just been lost.

Losing a set of keys or a £10 note is one thing

but to misplace a pair of St Bernard puppies, that really takes some doing.

With no vet records and a dubious set of circumstances,

Agria had their doubts too.

It was very suspect.

We couldn't gather the evidence to prove that the puppies hadn't existed

or that the policyholder didn't own them

so the ultimate resolution to that was that we paid the case.

So that's one claim and one pay-out.

Of course, it may have just been bad luck.

However less than a year later,

another claim form landed on Agria's doorstep from the same policyholder.

This time it was £350 for a poodle puppy that had died

but once again the details were sketchy at best.

It had an illness but it hadn't seen a vet so we couldn't establish

that the animal existed or that the policyholder had owned the animal.

Then when the animal died there wasn't a veterinary certificate

because the vet hadn't certified it dead.

With the claim raising so many unanswered questions,

Agria rejected it and didn't pay the policyholder a penny.

It is possible that the policyholder could have been very unlucky.

I think with the lack of pushback from them,

perhaps we made the right call in that instance.

But this wasn't the last Agria heard from the claimants.

Just over 18 months later, they received another claim form.

This time it was an encore of the disappearing dog act,

except that this one was a pedigree bulldog worth over £2,000.

The policyholder had set the puppy loose in the back garden,

come back ten minutes later and the puppy was missing.

The puppy was actually a year old,

but that wasn't the only thing about the claim that didn't quite add up.

Quite bizarrely for a year-old animal, it had never seen a vet

so it had no veterinary records,

and when the breeder had submitted the purchase receipt,

surprisingly it had got lost in the post.

Suspicious that the missing bulldog was in fact just a load of bull,

Agria decided to investigate.

We sent the loss adjusters out.

They couldn't verify that the puppy had or hadn't been lost

so on the balance of probabilities we settled the claim.

So that's three claims and two pay-outs to the same policyholder.

But just over a year later,

Agria's paths crossed with the claimant once again

when they spotted something on the paperwork which set alarm bells ringing.

When the claim form came in, it was from a completely different address,

a completely different policyholder,

but on the front of the claim form was one of the addresses

the previous policyholder had been using

and that address was given as the address of the breeder of the puppies.

So instantly with the past history, there were suspicions raised.

Unsurprisingly, Agria wasted no time in investigating the claim

but when they visited the owner, they made a rather unusual discovery.

There was no indication that dogs had ever lived there

in terms of bowls, in terms of leads,

in terms of baskets, in terms of dog food.

So we were highly suspicious.

After the visit, the owner ceased all communication with Agria

and with zero evidence that the dogs ever even existed,

the case was closed.

So that's four claims and two pay-outs

but, you've guessed it, that wasn't the last time

Agria dealt with what had to be the world's unluckiest dog owner.

In this instance it was a pug puppy

and the pug puppy had got parvovirus

so this was a claim for veterinary fees.

The puppy did subsequently die but initially on the original claim,

parvovirus is something that the insurance policies

expect owners to vaccinate the animal against.

Probably because of the nature of this dog owner, this breeder,

this dog dealer, he hadn't bothered with the vaccinations.

So no vaccinated puppy, we declined the claim.

This time the owner's track record

of never taking his dogs to the vet had backfired.

Further investigations revealed

he had another six policies in place ready to make claims on.

Although as far as Agria was concerned, this dog had had its day.

If people are determined to defraud insurers,

sometimes they will find a way.

Luckily in this instance, we stopped three cases,

stopped a potential six others.

The downside of that was we paid two.

In January 2012, the police joined the fight against insurance fraud

by forming an elite squad known as IFED,

the Insurance Fraud Enforcement Department.

I would say to anyone who is considering committing

insurance fraud that now this is no longer a crime without consequence

as it may have been in the past.

There is a dedicated 40-strong unit known as IFED

that works 24/7 hunting down insurance fraudsters.

They've made over 450 arrests

and saved millions of pounds in fraudulent insurance claims,

money which ultimately goes back in our pockets.

From now on, fraudsters need to watch their backs.

If you are thinking about it, I would think again.

There's every chance you'll get an IFED detective knocking on your front door.

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

It's 5:30am and a team of IFED officers are on their way

to give another suspected fraudster one of their unique wake-up calls.

Aman Taylor is heading up today's operation.

This morning we're going to an address to effect an arrest,

hopefully of a male who we need to speak to regarding an insurance claim

for the theft of his tools.

They've subsequently paid him out £1,000 on the first occasion

and he's gone on to submit a further three claims

and they've paid out £3,000 in total.

It was the multiple claims on the suspect's contents insurance

that led IFED to suspect foul play.

What we'll look to do this morning is go in, arrest our suspect,

and search for any items relating to any offence, particularly fraud.

Having arrived at the address, the team prepare to go in.

We're from the Insurance Fraud Enforcement Department, City of London Police.

We need to speak to him, all right?

The person who's answered the door is claiming the suspect is at work

but IFED officers are a tenacious bunch

and have persuaded the person at the door to call the suspect.

He's now on his way home and can look forward

to a warm welcome from the IFED boys on his return.

He's at work, working nights. We've just phoned him and he's coming back.

He'll be back within the hour so we can hopefully speak to him then.

Sure enough, just under an hour later, the suspect arrives home.

You're under arrest by suspicion of fraud by false representation. You don't have to say anything.

It may harm your defence if you do not mention something you rely on.

Anything you do say may be given in evidence.

What we need to do is search inside.

We're looking for some items in particular.

We'll speak to you about the items we're looking for inside. What?

No, we're going to search this property under section 32

of the Police And Criminal Evidence Act.

It means we can search for any items that we believe are relevant.

We can search for any evidence at all under section 32

in the place you immediately come from, which is your home address.

With the legalities out of the way, the search gets under way

but the cameras remain outside.

Aman Taylor from City of London Police.

Almost an hour later Aman emerges from the property having made an interesting discovery.

Some receipts there, one for £100, and just some paperwork and his mobile phone.

We've seized his mobile phone because we believe that any photographs taken of tools

are more than likely going to be taken on a mobile phone

so we'll take that back to the police station, download it, download all the data from it,

and then from that we can pick the bones out of it

and see what information we want from the phone.

But weeding out documents isn't the only success of the day

because the team have also unearthed something that the local police

will be very keen to take a look at.

One of the DCs has gone out to the shed in the back.

There's a little outbuilding. We heard whirring from inside

and our suspect has said that he's growing 50 cannabis plants here.

What we're doing now is I've called the local police force down

to assist us with some uniform officers to dismantle it, seize it.

We'll probably seize all of the plants

and from that take a specific sample but it will be a crime

that will be more than likely investigated by the police.

For Aman and IFED, it's an unusual bonus.

After all, it isn't every day they arrest a suspected fraudster with green fingers.

He's quite a sophisticated seller.

He's obviously taken quite a bit of time to put it together.

The door is key-coded to get in which is something I haven't seen before

in nine years of policing.

As local police units arrive, the cannabis farm is dismantled

and bagged up as evidence.

As far as IFED is concerned though, today was all about

bringing a suspected insurance scammer to justice

and Aman is happy with the way the raid has gone.

I think we've got more than enough to look at.

We won't know until we interview him

and he's given an account of what he's got to say.

As the last of the cannabis plants are removed,

Aman reflects on the morning's events.

It's been a good result, good result all round.

We stumbled across something that's quite important.

Although not important to our case,

it will have a big impact on the local community.

Every year, thousands of us Brits

pack up and head off on our holidays.

But unforeseen circumstances

can mean that even the most perfectly planned trip away

never gets off the ground.

Thanks to travel insurance policies,

we don't have to be out of pocket when disaster strikes.

Although, in 2013,

the officers at the Insurance Fraud Enforcement Department

discovered someone who saw these policies

as a means of lining their pockets.

Joanne Hunt is a case we dealt with last year.

She was a mother of three children

and she booked a holiday to Lanzarote.

She booked this holiday two weeks before the flight,

and within two days she'd taken out seven policies of insurance

to ensure her risk against travel.

A couple of days before she was due to set off,

one of her children became unwell and she took the child to see her GP.

And the GP agreed that the child was unwell and would be unfit to travel.

A child falling sick is one of those things that just can't be helped.

But with seven insurance policies in place,

Joanne Hunt was able to help herself.

And that's precisely what she did.

She made the claim on the policies,

so the insurance companies sent her the claim forms

and she made a claim on all seven policies.

So the holiday cost 1,600 and, had she been paid out on all seven,

she would have been making about £11,000.

Almost £9,000 profit in the space of a few weeks

wouldn't have been bad going.

But fortunately, defrauding insurance companies isn't that easy.

The fraud was uncovered when the insurance companies,

they do talk to each other,

and they communicated that they were all about to pay out on a policy.

So when they discovered that, they froze the pay-outs

and referred the case to ourselves.

With IFED now running the investigation,

Joanne Hunt was brought in for questioning.

Joanne Hunt gave an explanation in interview

which had to be checked out, so we went to see her GP.

He confirmed that, yes, he had seen her young daughter

and she had been unwell.

The seven claim forms were shown to the GP,

and whilst he confirmed that he had signed one of the policies,

he also said that the other six were forgeries of his signature.

In order to commit this fraud, Joanne Hunt had to forge several documents.

The first one was the policy of insurance.

She had to lie on that form to say she hadn't taken out other policies.

She forged the signature of a doctor

and also made a stamp from the surgery to authenticate the policy.

There was never any dispute over the fact that Joanne Hunt's child

was unfit to travel.

But because she'd lied and forged documents

to claim on multiple policies,

IFED were now dealing with a clear cut case of fraud.

But of course, Joanne Hunt had what she thought was a fair explanation

of her actions.

At the time, I don't think she realised how serious this case was.

But when she was interviewed at the police station by IFED detectives,

she tried to explain that the reason

why she took out seven policies wasn't in order to commit a fraud.

She thought she'd take out seven policies

so that when the paperwork arrived, she'd then look at the small print

and decide which policy she wanted to continue to take out.

The remaining six she said she was intending to cancel.

But she didn't.

And she went on to claim on all seven policies.

Unsurprisingly, IFED didn't buy Joanne's excuses,

and so she was charged with seven counts of fraud

by misrepresentation.

By the time she got to court,

she realised that the court may not have accepted her excuses,

and having taken legal advice she pleaded guilty in court.

She was sentenced to a suspended prison sentence

and she also received community service and a fine and costs.

Like so many other scammers, Joanne Hunt had been seduced by greed

and the prospect of making easy money.

But she discovered the hard way that fraud is a crime which doesn't pay.

Joanne Hunt was a young mother, 28 years old, a mother of three children.

And what set out to be a family holiday in Lanzarote

turned into a nightmare for her

and she's lost her good name for life.

Having investigated cases like this for the past two years,

Dom knows full well

what the consequences of insurance fraud can be.

I think generally, the fraudsters who commit these crimes,

they do think it is a faceless crime.

But in fact every person in the country

who has a policy of insurance,

whether it be for travel, whether it be for household, health,

we are all paying the extra on our policies because of the fraudsters.

With £2 billion a year lost through insurance fraud,

companies are doing all they can to fight back.

But one of the biggest problems they face is that

lengthy investigations cost time, money and resources,

which could be devoted to legitimate claims.

The key to winning this battle is to try and identify

fraudulent cases as quickly as possible.

And one of the ways insurers are doing this is by using the likes

of Sally Griffiths and her team of desktop investigators,

who are trying to spot dodgy claims over the phone.

What we are really listening out for is what they say,

but also how they say it.

Signs of nervousness, hesitation,

any indication at all that the customer is perhaps buying time

or being evasive,

using certain techniques that we call parroting -

repeating the question back,

so that we know there's something not quite right.

They can't answer the question fluidly.

But the advantages of these techniques don't end there,

because Sally's team have also managed to identify

which type of insurance fraudsters think is the easiest target.

People believe that it is easier to commit travel insurance fraud

without getting caught.

And also they believe it's not going to affect their

no-claims discounts, as it would for a motor or a household claim.

And believe it or not,

travel insurance fraud can even be affected by the weather.

During the summer months we do have an increase in claims

coming through, as people are obviously going on holiday.

A particular trend we saw last year involved the nice weather

that we had in England,

and we found there was an increase in cancellation claims.

So it seems that people were cancelling their overseas holidays

in order to save money on that holiday,

and then stay at home and enjoy the sunshine here.

So, for anyone who thinks that conjuring up a bogus claim

on their holiday insurance could be a nice little earner,

Sally has some words of warning.

People think that making a false travel insurance claim

is going to be really easy.

They can just come on the phone and speak to someone

and it will all be done and dusted.

The reality is, if they are speaking to a trained investigator,

every lie that they say will be picked up on

and they'll be caught out.