Episode 9 Claimed and Shamed

Insurance fraud in the UK has hit epidemic levels.

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

That's almost £6 million a 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 around 14 fake claims every hour.

Armed with covert surveillance systems...

Subject out of the vehicle...

..sophisticated data analysis techniques...

..and a number of highly skilled police units,

they're catching the criminals red-handed.

Just don't lie to us!

All those con men, scammers and cheats on the fiddle

are now caught in the act

and Claimed And Shamed.

Coming up:

A bus company pulls out all the stops.

A blue Nissan Almera pulled out in front of it,

and then the driver slammed on the brakes in front of the bus.

A claimer goes completely overboard with a personal injury claim.

The claim was a substantial figure -

in excess of £500,000 for his ongoing losses.

And IFED are on the trail of a suspected crash for cash criminal.

Well, we've got an intercom with a camera on the door,

which isn't really fitting with the area or the premises, is it?

Being a bus driver can be a tricky business.

There are just under 200,000 casualties a year on British roads.

One in 40 of these involve a bus or coach.

Buses provide an important service, so drivers are highly trained

to be amongst the safest motorists in the world.

But, when accidents do happen, it is not always the bus's fault.

This incident involved our 301 service,

which runs from Peckham to Waterloo.

It was in the summer, 6pm in the evening,

and our bus was proceeding along the road

when a blue Nissan Almera pulled out in front of it,

and then the driver slammed on the brakes in front of the bus.

In a matter of weeks,

the bus company received a claim from the Nissan driver for £3,500.

Abellio did not hesitate in investigating it.

The circumstances were quite peculiar.

As a matter of course, we did everything that we usually do,

contacting the call centre, filling out the incident report.

Luckily, each bus is fitted with the latest technology.

On average, across our fleet, we've probably got about 12 cameras,

but it can go up to 15 cameras on some of our double-decks,

and the minimum is about ten on a single deck.

They cover all the angles outside and inside.

There's nothing you won't be able to see

when we've got an incident.

They watched the CCTV footage back, and what they saw rang alarm bells.

The Nissan car pulled out in front of the bus,

and then started to travel slowly.

The bus driver had to slow the bus down

to increase the distance between the two vehicles.

The Nissan in front then suddenly slammed on his brakes.

The bus went into the back of it.

The reality of the situation was obvious, just purely from the CCTV.

There was nothing in front of the vehicle to cause him to brake.

The Nissan driver's behaviour was also a little unusual.

The driver then acted very peculiarly.

He got out of the car, would not talk to our driver,

and immediately was talking on his phone.

All in all, it was very clear to us

that something suspicious was going on.

We instructed the police straightaway.

DI David Hindmarsh from the Met Police came on board

to help Abellio with their case.

David heads up Operation Catcher, a police unit which identifies

and prosecute crash for cash offenders, with the unit

handling up to 50 investigations and making over 300 arrests since 2010.

Abellio came to us because they were suspicious.

Having reviewed the CCTV that was on board the bus,

they believed that the car in front

had deliberately slammed on its brakes,

doing an emergency stop, causing the bus to crash into the back.

The bus had about 30 passengers on board that day,

some of which may have been standing.

Even the simplest of braking on a bus could have caused them

to fall over, injure themselves seriously.

The cops could clearly see what had happened

and put two and two together.

Having reviewed the bus CCTV,

and having the experience of these type of incidents,

we decided that this was potentially an induced collision.

It had been deliberately induced so that the car in front,

the Nissan Almera driver,

could defraud the insurance company and get some compensation.

Suspicious that this was an attempted crash for cash accident,

the Nissan driver was called in for questioning.

He was interviewed under caution and on tape.

The allegation was put to him that this was a deliberate act

for the purposes of claiming off the insurance companies.

He denied this.

He simply said the bus had been driving too close

to the back of his car and had collided with him.

The fraudster was convicted at Woolwich Crown Court

of dangerous driving and fraud by misrepresentation.

He was disqualified for 12 months

and given 100 hours of community service.

This was a good result for us.

It's good that the jury recognised that this was a cash for crash

and believed the bus driver.

They are difficult to prosecute.

There were 30 passengers on board that bus.

Any one of those could have been seriously injured or even killed.

I am happy that he's now got a criminal record

and will think twice about doing this in future.

A lot of thought goes into making the claim after the incident.

People sometimes think they can get away with it,

but given the equipment and the investment that the bus companies

put in, it's highly unlikely that they will ever succeed.

Coming up:

A claimer doubles his chances with his insurance claim.

The photographs that were supplied as proof of the damage

that was caused looked remarkably similar.

And, a claim for a piece of jewellery loses its glimmer.

Either he'd lost two bracelets,

or the bracelet that was lost on this occasion

actually didn't exist.

Exaggerated insurance claims come in all shapes and sizes,

from claimers adding on designer clothes to travel insurance,

to items of furniture onto home contents insurance.

But, top of the list is exaggerated personal injury claims,

especially those related to motor insurance. And they are on the rise.

It does appear that these types of claims, where gross exaggeration

in order to obtain financial gain is becoming more common,

and insurers are finding more of them,

and investigating more of them on a year by year basis.

One insurer received a claim relating to a car accident

in the summer of 2011.

The claimant alleged he'd sustained the injury as a result

of the defendant's vehicle shunting into the rear of his.

There was some concern that the symptoms presented,

and the manner in which he stated the incident occurred,

was exaggerated - and he alleged it was forcible,

but the defendant was actually disputing that,

stating it was only a very minor incident

that had occurred in a 20mph zone.

An accident can be traumatic, especially serious car accidents,

with those injured suffering both physical and mental injuries.

The claimant was alleging that he was unable to stand or sit

for any longer than 20 minutes without the onset of pain.

He was also alleging he was not able to carry anything heavier

than light shopping bags, and in addition, most importantly,

he was unable to work, and had had to give up his job

as a direct result of the injuries he suffered.

With a prognosis of only 50% recovery,

and the possibility of needing a full-time carer for the future,

it wasn't looking good for the injured claimer.

The claimant's claim was a substantial figure,

which was reserved in excess of £500,000 for his ongoing losses.

With the prospect of paying out such an enormous amount,

the insurer called in their lawyers, BML.

Following receipt of the instructions,

we immediately started to investigate the claim,

questioning the extent of the symptoms the claimant was suffering,

and also putting him to strict proof that the losses

were suffered as a direct result of the road traffic accident.

When the lawyers contacted the claimer's employer,

they couldn't believe their ears.

His employers actually provided us with a statement

to the effect that he was able to drive his van,

he was able to actually lift and carry

significant crates and containers,

which weighed approximately the same as a washing machine,

and he was able to undertake all of this

whilst he was reporting to medical experts that he was unable to work.

The plot thickened when further clues were uncovered online.

We searched social media

and obtained images which seemed to show

that the claimant was able to undertake tasks

such as carrying his child,

and also his mobility seemed far greater

than he was reporting to his medical experts.

The insurers had no doubt that the claimer

had blown his personal injuries out of proportion.

To save incurring substantial litigation costs,

and the risks incurred around pursuing this claim further,

we would make a significantly low offer to the claimant

to settle his claim, highlighting we had concerns

over his credibility

and the fact that we did not believe all of the symptoms presented to

his medical experts were an accurate picture of his true day-to-day life.

Realising that he'd been caught out,

the claimer was willing to negotiate his claim.

The case actually concluded at a very significantly low figure,

approximately a few thousand pounds,

which was against the case reserve of over £500,000.

So, there were substantial savings made.

He ultimately accepted our very low offer

and walked away from the claim at that point in time.

In January 2012, the City of London police joined the fight

against insurance fraud by forming an elite squad known as IFED,

the Insurance Fraud Enforcement Department.

The message I give to people that are considering embarking

on insurance fraud is just don't do it.

My team day by day are getting more sophisticated in tracking down

the people that want to try out this type of crime, so really,

if you want to get into insurance fraud, I would say don't do it.

They've made over 550 arrests,

and have 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.

My team worked tirelessly 24/7 so we know exactly what types

of scams you're going to embark on, and we will come after you.

Police, don't move, stay where you are!

Today, IFED are cracking down on car insurance fraud.

DS Marcus Allen and his team of officers are on the trail

of a suspected crash for cash criminal.

After months of research,

the suspect is known to move around a lot,

so the team are hoping to catch him at one of three different addresses.

But, as he moves flat every few months,

it could be a frustrating morning for the team.

They're en route to the first property.

We're heading off to arrest a male, believed involved with others

taking out motor vehicle policies and then making claims for

fictitious accidents where personal injuries have allegedly happened.

They're only a short distance from the address.

'Turn left in 300 yards and then you will reach your destination.'

They arrive at the first address, and are parked around the corner

so as not to tip the suspected criminal off.

IFED often rely on the element of surprise,

hoping to catch the offender on the hop.

But they have to move swiftly so as not to alert the alleged fraudster.

Their intel has brought them to a multiple occupancy property.

These significantly increase IFED's work as it means the team

has to knock on every door within the house, and check all

the innocent residents to ensure their suspect is not among them.

Good morning. I'm from the City of London Police.

These officers are with me. We're here today to look for a...

What is your name?

It looks as if IFED are too late and the suspect has moved on.

But Marcus and the officers want to make certain.

OK, may we come in and confirm who you are and who lives here?

Like we say, we are from the City of London Police.

We are all police officers.

We're investigating an offence where this address has been named.

Do you have any identification, please?

On entering the house, the officers attempt to verify the identities

of those present, including anyone who seems completely innocent.

Have you got a driving licence, or anything with your name on it?

-Driving licence or passport.

-So we can see you are who you say you are.

Thank you.

OK, yeah, fine.

From the officers' inquiries, the identification checks out.

I'm satisfied that the persons here aren't connected,

and that the male we are looking for has actually moved

out of the address, so we're going to finish off taking details,

reassure them,

let them know that there's no police involvement with them,

and then move on to the next address and look for the suspect there.

IFED waste no time in getting to the next property,

hoping to be hot on the heels of their suspect.

Within minutes of Marcus arriving, the occupants open the door.

Good morning. We are from the City of London Police.

We believe that this address has been used to facilitate some

car insurance fraud. OK?

We're looking for... Does he live here?

But, once inside, it's the same scenario,

which means more searches and ID checks

but no suspect.

Good morning, sorry to disturb you.

We're from the City of London Police. We're looking for...

Is that you? OK.

As we're here in the process,

have you got some identification, please, for you and the lady?

The officers check the ID of the people at the property,

but it's another dead end.

None of our suspects live here.

It's a multi-occupied address, so we will just verify everyone

here, their identities, and do checks on them.

If that's all satisfactory, we will now move on to the third address.

With such a transient suspect,

the team have their work cut out trying to track him down.

Marcus's day is not exactly going as planned.

The day's operation is being renamed Wild Geese.

Whilst it's frustrating that not all raids go to plan, the IFED team

is able to gather information about the suspect's movement,

and they can now eliminate the other location from their search.

Sadly for Marcus and the team,

conducting a mini tour of the area is just part of the job.

But they have another property to check out.

Within minutes, Marcus and the team arrive at their final address.

Anything? No?

Well, if it is, they are not going to answer the door, are they?

I'll just have a look.

No-one has answered the door, and they can't tell if anyone is in.

But something about the property doesn't seem right to the officers.

They've got an intercom with a camera on the door,

-which isn't really fitting with the area or the premises, is it?

-No.

The property appears unoccupied.

However, somebody has gone to great lengths to make it very secure.

There's a camera intercom on the door.

The lock is quite a sizable, expensive lock,

and at the back, there's foil lining on the windows,

so we're quite keen to get inside and find out what is going on.

Time is running out, but entering by force is seen as a last resort.

With the help of officers back at base,

Marcus attempts to track down the house owner.

One of the officers has contacted the landlord, is speaking to him now

to see if he will let us in to check there's no suspects in the flat.

The property owner is on their way to assist the officers.

But, just as the team are preparing to enter the residence,

they get a call from a colleague.

The outcome is this premises, we have found out that it was

a brothel with prostitutes working here.

Hence the security measures that they've taken.

We've now confirmed with the landlady that it is empty,

and we've spoken to the local police who've confirmed

that they've taken action and it's now empty

and there's no criminality going on there.

Unfortunately, it's been an uneventful day for Marcus

and his team, who'll return to the office empty-handed.

They may not have found the suspected criminal today,

but will continue with their investigation and won't rest until

they bring this and any suspected crash for cash criminals to justice.

Accidents happen all the time in the home,

from spillages on carpets to accidents with a hot iron,

which is why accidental damage is one of the most common reasons

for making a claim on home contents insurance.

With advances in science and forensics,

insurers can determine the truth behind some of these claims.

Dr Andrew Moncrief works for one of the leading forensic science

organisations in the country.

For any incident, if something falls over, bends,

breaks, blows up or is damaged,

it'll be damaged in a way that follows various physical laws.

And those laws are often predictable, often easy to study.

If we come across something which seems to suggest that those

laws have not been followed, then it implies human intervention.

In his time, Andrew has helped investigators with many

accidental claims on home insurance,

from spills of nail varnish on sofas

to bleach and glue on carpets.

But one spillage crops up more often than others.

Paint spills are an interesting claim for us,

an interesting type of claim for us to investigate.

When you drop a tin of paint, it will spray itself round the room

and over the furniture in some quite unpredictable ways.

When we're faced with a paint spill, either on site or via photographs,

then once again we will be looking at those patterns,

which should follow fairly predictable physical laws,

and we'll be looking to see whether or not the pattern

is consistent with what the claimant is saying happened.

There are quite a number of fairly clear indicators with paint spills

that they have actually been done deliberately by a human hand,

rather than accidentally.

However, the use of Andrew's forensic skills by insurers

for household accidents does not stop there.

With an incident such as a claim for a damaged computer

or a damaged television, we'll look at things like stability.

Is it possible for the thing to have fallen off from where it was?

We'll then look at the surface it's landing on,

the height it's falling,

and we'll try to tie that in with test results from other items

to see what sort of damage we expect from the impact

that has been described to us.

We will also, of course, look at the number of impacts, because most

things, if they are falling accidentally, only do it once.

We'll see whether the damage to the television is consistent

with the manner in which it is supposed to have fallen.

And don't be fooled into thinking that a small claim won't be given

the same attention by an insurer as a claim for thousands.

It's actually quite difficult to simulate an accident perfectly.

The more complicated the accident, the more difficult it becomes.

If we dig deeper and deeper and deeper into the incident,

then there will nearly always be something to indicate

that the claim has been created deliberately.

But it is interesting

because the amount of money that an insurer is willing to spend

is sometimes considerably more than the actual value of the claim.

If they find that they really do want to make a point,

then we are sometimes funded really rather well

to carry on looking deeper and deeper into a particular incident.

Not only do people sometimes exaggerate their claims,

but they also duplicate them.

Insurer QBE received two claims related to a TV

that were remarkably similar,

with a faulty picture hook being at the centre of both claims.

In the claim that was presented,

it was alleged that the picture hook from the product was faulty,

and that it had fallen from the wall and damaged a TV casing.

When the claimant submitted some photographs to support their claim,

QBE thought everything seemed to be in order.

Their claim was submitted for reimbursement of the cost

of replacing the television.

QBE settled that case for the sum of £500.

However, 12 months later, another claim landed on their desk.

In 2012, QBE received a further claim for a faulty product,

which was a picture frame.

The picture frame hook was said to have been faulty,

and this fell onto some personal property, damaging a TV,

and a television unit as well.

Again, the claimer had photographs on hand to help support their claim.

The second incident that was presented to us

showed pictures of the television again,

but also some additional photographs that showed damage to the television

cabinet, and also the area of where the picture frame had fallen from.

Unluckily for the claimer,

the insurer thought these photographs looked familiar.

We immediately noticed on both instances,

the photographs that were supplied as proof of the damage caused

looked remarkably similar.

Let's just have another look.

These are the photographs relating to the first claim

of damage to the TV.

And these are the photographs relating to the second claim.

Yes, remarkably similar, I would say.

Although we could tell visually that the pictures looked the same,

it still wasn't enough to prove that they exactly were.

The investigator had a few tricks up their sleeve

and sent the photographs off for further examination.

We forensically examined those pictures,

and we looked at the metadata that sits behind them,

the metadata being almost a footprint of the image

taken at a point in time.

The photographs that were similar, but we suspected,

did in fact show the same date stamp as the original claim QBE received.

The claimer had been caught out.

But the insurer was not happy just to give him a slap on the wrist.

We felt we had enough evidence there to the criminal standard of proof,

and that decision was taken then to refer the matter to the police,

more specifically to the Insurance Fraud Enforcement Department.

The Insurance Fraud Enforcement Department, IFED,

didn't hesitate in calling the claimer in for an interview,

where he held his hands up.

He explained that the pictures that he had submitted in the second case

were indeed from the first incident.

That was a case that had been made by a previous partner of his

for the faulty picture that had fallen.

The claimer had the old photographs still on his camera.

Now he had a new girlfriend,

he thought he'd use these pictures to his advantage.

The claimer had made his girlfriend phone QBE

because he didn't feel he was able to portray himself well

on the telephone, and thus continue the claim that he had made.

The first claim was indeed genuine,

but, as the claimant had admitted that the second claim

was fraudulent, he was given a police caution.

He thought it was an easy way to make a claim.

Unfortunately, we were able to quickly identify that the

second case from that claimant was indeed a fraud.

If we lose a piece of jewellery, regardless of the value,

it can be upsetting,

even more so if it is of sentimental value or a family heirloom,

which is priceless,

whether it's your wedding ring or your grandfather's watch,

so imagine what our next claimant felt

when he lost a very special family memento.

In this case, our policyholder, a gentleman,

was out on the town with some of his friends

when he lost a bracelet.

The bracelet was not only worth £3,000,

but it was a family heirloom

which had been passed down from generation to generation.

A claim was made for the insured value of £3,000

within a month of the policy being taken out.

We began to become suspicious because this very valuable item

had not actually been reported as lost to the police,

which you would normally expect it to have been.

The insurer discovered that the claimant

had lied about his whereabouts that night.

The other thing we discovered was that the gentleman concerned

was actually not out on the town on this night, and was at home.

But, it seemed that social media was to be the claimer's downfall.

We made some inquiries, and in fact they were quite startling,

what we found out.

This bracelet had in fact been lost on a previous occasion

at some specific premises, and not, as alleged, on this night out.

Either he had lost two bracelets,

or the bracelet that was lost on this occasion

actually did not exist.

It turned out that the bracelet had been lost a few months earlier

in a gym. Now it was time for RSA to confront the claimant.

We challenged our policyholder and they asked to withdraw the claim.

But the insurer wasn't having any of it.

We were so incensed that this policy had clearly been taken out

with the specific intention of making a claim

that we reported the case to IFED, who took action against him.

The Insurance Fraud Enforcement Department, IFED,

continued with the investigation.

The claimant was then arrested and received a police caution.

He might have thought that this was worth the risk but ultimately,

he has ended up with a criminal record,

and he will of course also be on the Insurance Fraud Register

and will find it very difficult to get insurance cover in the future.