Episode 7 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 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 on Claimed And Shamed.

Coming up...

Surveillance footage scuppers an HGV driver's

claim for a truckload of compensation...

Without the surveillance,

we would have faced a claim into the many

hundreds of thousands of pounds,

and so it would have provided Mr Doyle with

a lottery win in compensation.

..a bone-crunching fall...

You can feel every single hit as he's falling down the stairs.

It was pretty harrowing to watch.

..and door-to-door enquiries IFED style.

It's the police, could you open up?

We will put the door in.

When it comes to catching someone out,

there's nothing like a bit of damming video evidence,

which is exactly what proved to be the undoing of HGV driver Lee Doyle

after he grossly exaggerated a personal injury claim.

Mr Doyle alleged that his accident happened

when he was walking across his employer's yard and tripped over

and fell, banged his lower back on a raised kerbstone.

Injuries to the spine can be very serious and in severe cases

can leave victims with numerous ongoing problems.

When the insurance company received Lee Doyle's claim,

it appeared that he was suffering from every back complaint in the book.

The injuries he was left with was a very stiff lower back, he had

sciatic-type symptoms with dead legs that meant he couldn't walk very far.

Whenever he did walk, he had to use a walking stick, that he

couldn't bend or lift or carry, and in particular, he couldn't sit still

for very long periods which obviously affected his job as an HGV driver.

With a list of complaints as long as that, you'd think that

the doctor would be able to diagnose the problem in a heartbeat,

but the specialist who examined Mr Doyle was left scratching his head.

Unfortunately for Mr Doyle, the orthopaedic surgeon couldn't find any

reason for the nature of the injuries that he said he was suffering from

and because of that, he suggested referral onto a pain management consultant.

Unsurprisingly, the combination of Lee Doyle's supposed symptoms

and an orthopaedic consultant that couldn't find anything wrong

with him led the insurance company to suspect foul play

so they referred the case to their solicitors, BLM.

We had real concerns about Mr Doyle's claim,

simply because it didn't add up.

For somebody who'd had such a straightforward

accident of tripping and falling,

Mr Doyle said he was significantly disabled, for example,

he couldn't walk more than 25 yards,

he needed a walking stick to get about

and when his own expert couldn't find an explanation for the symptoms

he was describing, we thought it merited further investigation.

With Lee Doyle claiming his injuries were

so severe he could no longer continue working as a lorry driver,

he wanted his employer's insurers to cough up some cash.

He calculated his loss of earnings at £55,000.

There were other incidental losses,

additional help that he'd had around the home for DIY and gardening.

The important factor for us

was that Mr Doyle said he would find it impossible to go back to his

earlier job and so his future loss of earnings could well have

been into the hundreds of thousands of pounds.

But his claim for lost income was just the beginning as Lee Doyle

had a list of costs that was even longer than his string of injuries,

taking the total claim to around half a million pounds.

He also claimed for travel expenses to various medical appointments,

and strangely even to his nan's house because he said that he

couldn't shower at home so had to go to her house to shower.

He claimed for the additional care

and assistance that his partner had provided him in getting him

up out of bed in the morning and helping him dress in the morning.

He'd claimed for additional help that he'd had looking after his fish.

Mr Doyle's case was rather extreme in that there were some very

strange items of claim.

Faced with a potentially huge payout

but still not convinced that this was a legitimate claim,

BLM arranged for Mr Doyle to see a pain management consultant

and a neurologist but that's not all they did.

Because of the concerns that we had about the claim generally,

we arranged for covert surveillance to be undertaken.

The difficulty with that is that sometimes the surveillance

operatives can be sitting there and not seeing anything at all,

and so because we'd arranged medical appointments,

we knew where Mr Doyle would be on a particular day at a particular time.

With the injuries that Lee Doyle was claiming to be suffering from,

BLM were expecting the footage to show a man unsteady on his feet

and who needed help to perform even the most basic movements.

And as he arrived for and left his medical appointments,

that's precisely what they did see.

Case closed? Not quite.

Some of the surveillance we obtained of Mr Doyle you wouldn't

believe that it was the same person

you read about in the medical reports.

We were able to watch him

going into a medical assessment,

walking in a very disabled manner with a walking stick, presenting himself in chronic pain.

When we eventually got the medical report back,

he had told the expert that he had quite serious physical difficulties.

What we saw Mr Doyle do later in the day was simply amazing.

What he'd said on paper, where he couldn't walk for more

than 25 yards without a walking stick.

We were able to disprove that, showing that he was

walking his dog without any difficulty for over an hour.

He said that he couldn't bend at the waist

and lift things off the floor, but surveillance footage

showed that he was lifting without any real difficulty at all.

But the most shocking footage was captured just four hours

after Doyle had hobbled his way into a medical examination.

In it we see him hoisting heavy concrete slabs above his head

onto a garage roof.

Steady on now, Lee. Mind your back, son.

His evidence was that he couldn't drive, yet he was able to

drive his own 4x4 vehicle without any apparent discomfort at all.

So, everything that we were being told simply wasn't borne out

by the surveillance footage that we were presented with.

The video evidence proved beyond doubt that Lee Doyle was

grossly over-exaggerating his claim,

happy to play the role of the weak

and wounded in order to receive a bumper payout.

But it was a performance that BLM weren't buying.

Once we had collated all the surveillance evidence

and we'd had the opportunity of having Mr Doyle examined

by our experts, we were waiting for court proceedings to be issued.

That was really the last chance that Mr Doyle had to come clean.

We didn't know whether he would be honest in his presentation

and say that he has tried to work, that he does have good days or

bad days, that he is capable of doing SOME physical activity.

When proceedings were eventually issued, he maintained that he was

chronically disabled, that he hadn't worked

since the date of the accident,

it was unlikely he was ever going to be able to go back to his former job,

and the claim that he presented in financial terms was very

significant - into the hundreds of thousands of pounds.

Our only response to that had to be that we disclosed

all of our medical evidence and all of our surveillance evidence

and pointed out that he'd been caught out.

Since his accident,

Mr Doyle had claimed around £25,000 in disability benefits.

So, upon hearing about the exaggeration of his claim,

the Department of Work and Pensions had a few questions of their own.

A separate investigation was undertaken by

the Department of Work and Pensions through their fraud unit.

We understand that Mr Doyle's benefits were stopped

immediately when the investigation was started.

Doyle was ordered to repay almost £25,000 but bogus disability

benefits weren't the only thing he had taken away from him.

We understand that he had tried to tender his resignation.

We were informed by the employer that his resignation wasn't accepted

and so we understand that a process of gross misconduct was pursued

and that eventually Mr Doyle was dismissed.

BLM's investigations had scuppered what could have been

a fraudulent claim in the region of half a million pounds.

Without the surveillance,

we think we would have faced a claim into the many

hundreds of thousands of pounds, and so it would have provided

Mr Doyle with a lottery win in compensation.

Instead, Lee Doyle was offered, and accepted, a £10,000 settlement

which is what BLM felt was the honest portion of his claim.

But that didn't even cover all of his legal costs.

He was now out of pocket and unemployed.

However, if this case had been resolved just a year later,

then things could've ended much more seriously.

I think Mr Doyle is a very fortunate man for getting

the level of compensation that we offered.

Times have changed, thankfully, since Mr Doyle put his claim in and

the way of the law now, we wouldn't actually be making any offers at all.

In fact, we'd be looking to pursue Mr Doyle for contempt of court

which may lead to a prison term.

Still to come, a nasty tumble

but did he slip, or did he trip?

Obviously it's very sad when someone gets hurt

but is he entitled to make a claim?

And IFED treat another suspected fraudster to

one of their special wake-up calls.

Hi. Police, open up!

What they're going to do is they're going to come round with

the entry team and gain entry that way.

Not the way we like to do it but he's leaving us no option.

In January 2012,

the police joined the fight against insurance fraud by forming an

elite squad known as IFED,

the Insurance Fraud Enforcement Department.

IFED is a dedicated team that deals with insurance fraud.

Whatever insurance policy there is out there, we investigate it.

There is a dedicated 40-strong unit that works 24/7

hunting down insurance fraudsters.

IFED has 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.

We are out there in numbers.

You might get a nasty knock on your door in the morning if you

commit this type of fraud.

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

With almost £400 million a year being lost through car insurance fraud,

it's something that the officers of IFED have found themselves

dealing with on a regular basis

and one of the biggest problems they encounter are crashes that

have been instigated with the sole intention of making money.

Crash for cash involves staged or induced accidents.

It's generally organised by people that know each other and a typical

example would be what's known as a "slam on"

where a vehicle will slam its breaks on with the sole

purpose of causing the vehicle behind to drive into it

and then make a claim as a result of that accident.

During their first year of operation,

IFED dealt with a crash for cash case which hit the headlines.

This case involves two families from the Birkenhead area in Liverpool

who reported that they were involved

in a road accident in the Wirral area in March 2011.

It all seems fairly standard so far. So what was the problem?

The claim involved a road accident at a set of traffic lights where

a BMW and a Rover were said to be in a collision.

Within these two vehicles were seven occupants that belonged to two

separate families and as a result of the accident,

all members then submitted claims for personal injury,

damage to the vehicles and vehicle recovery costs

and all told, those claims totalled £77,000.

At first glance,

this was a classic shunt between two cars at the lights,

but as the insurance company began to process the claims,

it became clear that this was anything but an ordinary accident.

It wasn't so much the value of the claim that raised the alarm,

it was the inconsistency in some of the detail

provided by the claimants to the insurers that caused them to make

a referral to IFED for further investigation.

By the time the case was handed over to IFED,

forensic engineers had established that the damage to the cars

didn't match up to the version of events on the claim form.

And as if that wasn't dodgy enough,

the insurance company had also discovered that

members of the two families already knew each other

and were friends on a social networking site.

This was clearly pre-planned and organised on a large scale.

The value of the claims is £77,000 so that shows the level of planning

and work that went into this crime.

After some investigations of their own, it wasn't

long before IFED made their move.

IFED sent a team of detectives up to the Birkenhead area,

affected the arrest of all seven suspects.

They were all charged

and sent to court where they were convicted of fraud offences,

so the main offenders, Kenneth Nash and Darren Gallimore,

both received custodial sentences, 12 months each in prison.

Nash, Gallimore and their accomplices thought

they could pull the wool over the insurance company's eyes

and pocket a small fortune in the process.

But they were sorely mistaken.

It should send out the message

if you don't want to get arrested,

if you don't want to go to prison, if you don't want to get

a criminal record, then don't commit insurance fraud.

Crash for cash doesn't just affect insurance companies though.

One tactic that fraudsters use is to hire cars, crash them,

and then cash in on personal injury claims.

Someone who knows, all too well, what impact this type

of crime can have is Tony Moore, who owns and runs a car rental company.

The effect on these cash for crash accidents to our company,

from a financial point of view, are immense!

Obviously it just pumps up the insurance.

Pumping up insurance means we have to put our prices up,

which obviously affects our business.

Two years ago, we had over £200,000 worth of claims.

That obviously has a knock-on effect on our premium the following year.

It's immense.

Tony has first-hand experience of how

a scam like crash for cash can hit a business' books.

But as an employer,

he also knows there's a greater cost to these crimes.

Additionally to that, if ever the insurance companies turn round

and say, "Look, we're not insuring you," then we shut the doors

and we all go home and I've got 46 people made redundant,

all caused by somebody trying to rip you off, cash for crash.

For now, Tony's business is managing to survive

but the threat of crash for cash is a serious concern.

It's not as people think a victimless, "it's just money."

It isn't money, it's people's lives.

With the likes of IFED clamping down and fighting

back against those who see car insurance as a way to make

a fast buck, Tony has some words of warning.

The message to those people out there that want to do this is

if we get a sniff of it, we'll go all the way to try and prove it.

And if we prove it, we won't just say "No, we're not paying you,"

we will push and push and push for a prosecution.

And the courts are starting to take it seriously now

and we're talking now incarceration.

As Tony rightly says, this is now a crime with serious consequences.

The good news is that the likes of you

and I are starting to benefit from the work of units like IFED, because

in 2013, the money saved from crash for cash scams reduced

car insurance premiums by 12%.

Although as far as IFED's concerned, they're only just getting started.

The Insurance Fraud Bureau estimates that the cost to the insurance

industry is £392 million per year from crash for cash scams.

So I mean that's clearly a huge amount of money

and it is an area that we're putting a lot of resources into to tackle it

and I'd like to think that with the results that we're getting

and the impact we're making, that we're

well on our way to targeting this type of criminality

and in the future, I'd like to think it will drop.

Just like lightening, you never know when disaster might strike,

but thanks to the boom of personal injury claims,

some accidents can have a silver lining in the form of a cash payout.

In 2013, public transport operator First Group dealt with

a claim from a gentleman who was making his way down the stairs

at one of their train stations when, suddenly,

everything went horribly wrong.

When you come across claims like this,

the first thing you normally think of when you see the injury is

"That's going to hurt," and seeing the footage just hammers that home.

It's never nice to see anyone get injured in any way

and although you don't know what injuries he's sustained,

you can feel every single hit as he's falling down the stairs.

It's not nice and I do feel sorry for the gentleman concerned.

Thankfully, there were a number of people on hand to help

the man out, although it was later discovered that the fall was

every bit as bad as it looked.

The injuries sustained were quite nasty.

He's got some minor bruising, but his main injury is actually

a fracture to his knee, and that has got to hurt.

It goes into the knee joint.

It's very painful to walk on after

but at the time, he must have been in excruciating pain.

Even though it was a genuine accident, it wasn't

long before First Group received a claim from the man's solicitors.

This gentleman alleged that he'd slipped

when he'd got to the halfway point coming down the stairs.

People don't just tend to slip on nothing, so he's assuming that

therefore it was our fault, we caused him to fall down the stairs therefore

he's entitled to compensation for his rather nasty injuries.

If First Group were at fault, then the kind of payout that

the man could have been looking at for injuries as severe as this

certainly wasn't an amount to be sniffed at.

Overall, this claim was probably worth in the region of £50,000 for his compensation

for his injuries, any potential loss of earnings claim,

and the legal fees that would have ensued.

So, we have an accident that definitely happened,

serious injuries that were sustained

and a claim for around £50,000 compensation.

It all sounds fairly standard

but before companies like First Group get out the cheque book,

they want to be certain that the blame lies with them first.

And that's where CCTV can be an invaluable source of evidence.

I actually don't think that people realise just how much CCTV

footage there is at a railway station, and they give very good

coverage of the area. People just don't even know they're there.

In this case, there was a CCTV camera in prime position at the top of the stairs,

so First Group had a bird's-eye view of exactly what happened.

When we receive claims like this,

what we're going to look at when we view the footage is

did anyone else have a particular problem walking along that

passage or stairways?

What ideally you're looking for is people walking down

with no problems at all which would suggest there wasn't a slip hazard

because we just don't know what this gentleman had slipped on.

But when First Group viewed the footage, there didn't appear

to be any evidence of a slipping hazard, or indeed any hazard at all.

One of the key points you'll notice from the actual CCTV evidence

is the small child actually joyfully skipping down the stairs with

no real problems at all,

even stepping on the section where the gentleman alleged he slipped.

Why, then, is this chap alleging that he's slipped on a step

that was previously OK for the people that preceded him?

It's clear there was no slipping hazard on those steps, otherwise

that small child, who had taken a jump at it, would have gone flying.

So, if the man hadn't slipped like he claimed,

then what really did happen?

He put his left foot down, planted that quite normally.

As he goes to step forward with this right foot,

it gives way beneath him.

This then causes him to stumble forward.

At the same time, in an unfortunate series of events, his trailing foot

then catches the bag he's carrying which flips him over and he virtually

somersaults down the stairs,

striking probably every single step on the way down and

when I watched the footage,

I did actually say, "Ouch," to myself every time he hit the step.

It was pretty harrowing to watch.

The severity of the fall had never been in doubt,

but with no evidence to suggest that any blame lay with First Group,

they didn't feel that the man was entitled to any compensation.

Once we reviewed the footage

and realised that what the gentleman was saying was not actually true,

we sent off the details of the CCTV to his solicitors

and told them that we just weren't going to pay this claim out.

They subsequently closed their file and we've not heard from them since.

Were it not for the CCTV footage,

this chap could have walked, or rather limped, all the way

to the bank by claiming there was a slipping hazard that never existed.

But situations like this are nothing new

and companies like First Group are finding themselves dealing

with more and more people looking to pocket some easy money.

I think the practice, from a legal point of view, it has become

so easy to put a claim in on behalf of the person

on the off-chance that they will receive a payout,

does encourage some people to submit claims they otherwise wouldn't.

Sometimes people know they've had an accident and it's no-one's fault

but they're encouraged to try and make a claim for it anyway.

Although this case was dropped with no further action,

there have been many instances where fraudulent claimers have been

prosecuted and even sent to prison

which begs the question - is it really worth it?

Obviously it's very sad when someone gets hurt,

but is he entitled to make a claim?

I think people are very hung up on the fact that

if something happens to them, they're entitled to make

a claim from someone and accidents don't just happen. Well, they do.

Not everything that happens to you, you can blame someone for.

Sometimes it's just an accident.

It's early morning

and two teams of IFED officers have headed up north to carry out

a dual raid in a suspected case of car insurance fraud.

DC Andy Jackson is the officer in charge of one of the units.

What we plan to do today is we've got two warrants to attend

simultaneously two addresses and what they've done is they've

both submitted claims for theft from their vehicles.

The value of the thefts is in the region of £16,000.

It's believed that they've done it on a number of occasions.

The suspected fraud is thought to have used quotes that were

doctored to make them look like receipts,

so IFED have got a pretty good idea of what they need to find today.

We'll be looking for material which will assist the investigation.

We'll be looking at probably computer evidence -

if there's a suggestion that they've altered this documentation.

They may very well have scanned that onto a computer.

Today, IFED are being assisted by local police units, so the

first stop is the local station for a briefing and to get kitted up.

You just never know who you're dealing with,

people's reactions sometimes when they, you know, get arrested,

or police turn up at the address, you know, someone...

People just react in different ways.

So, we're just going to make our way there now and see how we get on.

With everything set, the teams roll out.

Hello, Mick, look, we're literally going to be here in about a minute.

Do you want us to go straight in? We'll go straight to the house.

Cheers. All right, bye, mate, bye.

After a final phone call with the other IFED team,

Andy and the boys go in.

Hello? City Police, open up!

It's not unusual for people wanted by IFED to make a run for it.

So, just in case today's suspect decides to do

the old back-door shuffle, local officers cover the exits

although it looks as if the team may be too late.

It's the police. Can you open up? We will put the door in.

Word has come through that the suspect at the other raid has been arrested.

But no-one is able to get hold of the elusive home owner who lives here.

Although with crucial evidence to find, Andy and the team aren't leaving without it.

Right, it looks like what they're going to do is they're

going to come round with the entry team and we'll gain entry that way.

Not the way we like to do it but he's leaving us no option this time.

We've tried all numbers and all other means to

get in touch with him, but we've been unsuccessful.

With the front door just moments away from being

taken off its hinges, the suspect returns the team's phone call.

Hello? Yes, it's DC Andy Jackson from City of London Police.

I understand you're on your way back to this address? Excellent, OK.

All right. How far are you away?

Lovely, all right, we'll see you when you get here

and we'll explain all.

Thank you, bye.

All right, he's on his way. He's five minutes away.

Someone's just pulled up so...

And sure enough, just a few minutes later, IFED get their man.

You all right? What we'll do is remove the car,

if you can park your van up on the drive and then what we'll do,

we'll get you to open up, we'll go in, and we'll explain all.

The cameras remain outside the property...

What I'm going to do now is I'm going to be arresting

you on suspicion of fraud by false representation into those claims.

All right? So, for that, you do not have to say anything,

but it may harm your defence if you do not mention

when questioned something which you may later rely on in court.

Anything you do say may be given in evidence.

..although it isn't long before the suspect is brought out

and taken away for questioning.

He was a bit surprised to see us here,

but he's been co-operative and he's been compliant

and he's willing to assist us in our enquiries.

With the formalities out of the way, the search can begin.

Almost half an hour later,

Andy and the team emerge from the property having seized

a number of documents, mobile phones,

and a laptop which may contain crucial evidence.

Laptop's always handy

because computers can be used to alter documentation.

Documentation can be scanned into them

or indeed documentation can be created on them.

Due to the fact that he has had access to it, this is

something we can take back to London and review at a later date.

For Andy and the team, the work has only just begun.

But after a shaky start, things are looking up.

It's been a good day in the fact that what

we needed to do today has been achieved.

Our objectives have been achieved. Job done.

The suspects were later interviewed under caution and the case is

still under investigation.