Episode 1 Claimed and Shamed

Insurance fraud in the UK has hit epidemic levels.

It's costing us over £1.3 billion every year.

That's almost £3.6 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 14 fake claims every hour.

Armed with covert surveillance systems...

That's the subject out the vehicle.

..sophisticated data analysis techniques...

Police!

..and a number of highly-skilled police units...

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 failed personal injury claimant kicks off.

I think he was a little upset with the way in which

I cross examined him,

and as I left the court building,

I found him following me down the street.

A jailbird fails with a performance that falls flat.

The incident was so obviously staged.

If there was a scale of one to ten as an actor,

he'd be at the very bottom of this scale.

And a drunken driver gets smashed.

He appeared drunk and then began to get quite aggressive.

'And then he proceeded to punch the policeman.'

The UK is host to an estimated five million CCTV cameras,

meaning the country has one of the highest rates of cameras

per person in the world.

And they are one of the most powerful weapons in the

insurers' armoury when it comes to shooting down fraudulent claims.

CCTV was to prove vital in the case of a motor insurance claim

that was presented to insurers LV and investigate it by Claire Lunn.

The claimant alleged that our insured

had reversed back into his parked vehicle at such

a force that it threw him forwards and backwards in his vehicle.

Whilst our insured admitted that they had reversed back into the vehicle,

they said that the vehicles had literally touched.

Colin Bushell of LV's solicitors, DWF, also worked on the case.

There were no injuries to the driver of the...

sort of fault vehicle, as it were, but the claimant

who went on to make a claim for personal injury

had various alleged losses.

So there was an injury claim, there was a claim

for care and assistance.

He claimed for damage to his vehicle, which he

alleged had been written off,

and there were other sort of minor

losses that he alleged, miscellaneous expenses.

Care and physio and things like that.

So at the outset,

the driver is suggesting that he's thrown around inside the car,

and as a result,

he suffers what people would know as a whiplash-type injury.

He suggested that he required help getting dressed

or washing his hair, and that was provided by his partner.

He also suggests that he couldn't play football or golf,

which he said he did two or three times a week.

He also says that the collision caused damage to his car

which wrote it off, which is something that we had to look at.

He put forward a claim in the region of £5,000,

so if he were to succeed on everything he was asking for,

that's what the insurance company would have expected to pay out.

You'd expect the driver's cost to be in the same region,

wouldn't you?

The total cost of the claim to our insurance vehicle

came to a minor £65.62.

Hang on, £5,000 on one side versus £65.62 on the other.

That's a whacking great difference of £4,934.38.

Something wasn't adding up,

so the insurers went back to their driver to get her side of the story.

She immediately said, "This isn't right.

"He didn't tell me at the scene he was injured.

"He's certainly describing a collision

"which I can't describe myself."

It was very low speed as far as she was concerned.

And she didn't agree at all that this individual

could have been injured.

So, yes, she was surprised

and quite angry at the thought that a claim could have been made.

Someone wasn't telling the truth,

but one thing that never lies is the camera.

CCTV allowed insurers to find out what had really happened.

So we were quite lucky in this instance

because the lady actually worked in the building adjacent to where the

accident happened, which happened to have CCTV cameras outside.

So she made initial enquiries and advised us that footage was

available, which formed part of our initial assessment of the claim.

We were able to look at those images and assess what she was saying

and what the claimant was saying, which was exceptionally helpful.

You can see the woman getting into her car.

Now, brace yourselves as you're about his witness

a really nasty crash.

No, you haven't missed it - that was it.

So the footage quite clearly shows this is a very gentle impact.

It's a kiss between the two vehicles and I can see quite clearly here

you just about make out that the claimant's vehicle rocks.

Nothing more, really.

You certainly don't see him

get thrown around as he suggests happened to him.

And almost immediately he is out of the vehicle,

walking around, looking between the cars

to say - or examine - what potential damage may have been caused

as a result of this very small collision.

It's almost as if he's rubbing off dirt from the front of the bumper,

to be honest with you.

We certainly wouldn't say that he suffered a gross injury.

He certainly doesn't look like he was thrown around

and needed help to get out of the car as he suggested.

There is certainly nobody helping him get out of the car.

So when I first saw this footage, I thought

it was incredible what this gentleman was saying.

I didn't believe at all that he could have suffered

the injuries he'd alleged.

The footage was then forwarded to other party

with the expectation that the claim would be dropped,

but they couldn't have been more wrong.

Well, the claimant, or the face of the claimant - his representatives -

were very dismissive of the footage, which surprised us.

We expected them to pretty much hold their hands up and say,

"OK, we think we've been rumbled. We'll walk away from this."

The footage was treated in almost a blase way, to be honest with you,

in that the claimant said, "No, I'll basically see you at trial.

"Let's go."

Despite the overwhelming evidence against him,

the claimant had the nerve to take the case all the way.

The insurers appointed an experienced barrister, Mark Roberts,

to represent them at court.

My initial thoughts

when I got the case were that it was an interesting case,

lots of difficulties in the evidence from the claimant's perspective,

lots for me to have a go at, and the CCTV footage was a real bonus.

Oh, in my opinion, it was undoubtedly grossly exaggerated.

I'd probably go as far as to say that the claim for injury was entirely

made up.

It seemed to me wholly unreasonable to suggest that

anybody could be injured in circumstances such as this.

When the case reached trial,

the claimant took to the stand, and then perhaps wished he hadn't.

When I cross-examined, it was the best fun I'd had for some time.

He was an aggressive witness, he was a difficult witness, he refused

to answer questions, things had to be put to him in very different ways.

He pretended to fail to understand questions that were very basic ones

that were put to him, so it was a bit of fun.

Despite the CCTV evidence stacked against him,

the claimant had the cheek to keep to his story.

He tells the court that he's thrown about by the impact, which he's not.

But he's quite happily leaping out of the car and looking

at the front of the car and showing no signs of injury whatsoever.

There could be only one outcome.

He lost fairly and squarely.

And the judge simply didn't accept anything that he'd said.

And I think I would have been astounded had any judge

accepted anything that he put forward as honest, frankly.

One person who didn't agree was the claimant himself.

He later attempted to confront the man who had exposed his lies.

I think he was a little upset with the way in which

I'd cross-examined him. And as I left the court building,

I found him following me down the street.

I pointed out to him that following me

down the street potentially wasn't a good idea from his perspective.

Told him very politely to go away, put it that way.

The claimant made the first sensible decision of the case

and backed down.

Sadly, this is another example of a genuine minor accident

being turned into a moneymaking opportunity.

Ultimately, if we make payments on these types of claims,

it affects you as a consumer,

as an insurer...or an insured, I should say,

and a driver cos it goes to your premiums

and you end up paying the bill for this.

Still to come...

A would-be fraudster tries to blame his crime on the postal service.

The customer was claiming that the ring was in the packet when

he posted it and, therefore,

has been stolen by a member of Royal Mail.

And what happens when one of these...

That will be mine one day.

..meets one of these...

..and one of these?

-Oooh!

-BLEEP.

-Oooh!

-BLEEP.

Fraudulent insurance claims are a constant pain for the industry.

With a total of 119,000 fake cases in a recent 12-month period,

the problem is in danger of becoming endemic.

One man used to dealing with the sharp end of personal injury claims

is health and safety manager Colin Wells.

His workplace provides more challenges than most -

the Category B Dovegate Prison in Staffordshire,

one step down from maximum security.

The prison authorities are regularly hit with personal injury claims,

and the case involving an inmate by the name of Mr Delisser

was no different.

The claim that was received from Mr Delisser's solicitor

was that he was walking on the landing after emptying his bin.

There was some water that had accumulated on the floor

and he actually slipped into the water,

and as he was trying to get up,

carried on slipping, resulting in injuries to his right tendon

and to his back, which required further physiotherapy.

The injuries the prisoner suffered had potentially long-term

implications and could have resulted in a hefty compensation pay out.

It's Colin's job to make sure the cons aren't attempting a con.

Part of my role as health and safety manager

is to robustly look into each accident and incident.

Part of that information that I will gather together is the CCTV footage.

I'll get the accident report, any of the reports that go with it,

any interviews that we have off staff

and then this will be the package that I'll put together

or wait for the claimant or if the solicitor's going to come in.

As a matter of course, Colin also checked footage from the prison's

understandably extensive network of CCTV cameras

and it soon became clear that there was something fishy

about this watery accident.

The CCTV footage shows that...Mr Delisser walking

along the landing after emptying his bin.

He notices the water actually on the floor,

he points to the water on the floor

and then he gesticulates to a fellow prisoner across the landing

with his eyes, saying, "Look at me," and then points to the floor again.

Mr Delisser then carries on to complete his fall

actually onto the floor.

The incident was so obviously staged, if there was a scale of

one to ten of how the accident took place as an actor,

he'd be at the very bottom of this scale, it's that obvious.

So, no Oscar on its way then.

Apart from the criminally bad acting,

the involvement of another prisoner also gave the game away.

It makes it a lot easier for when you're trying to put a claim in

to have two people stating the same thing.

Despite his best efforts, the prisoner fell down on the basics,

failing to realise that a prison is possibly the worst place

to commit a crime,

what with all the prison officers and cameras everywhere.

I think prisoners do get complacent.

They must know that the cameras are there,

but because they are totally surrounded by them

all the time, they seem to forget that the cameras are watching them.

There was only one reason for him to do this and that was for fraud

and to get financial gain out of HMP Dovegate.

Needless to say, the claim was dead in the water,

but Colin wasn't prepared to leave the matter there.

I then took out a separate prosecution with Staffordshire Police

to go against Mr Delisser.

The reason I pursued this prosecution against Mr Delisser

was not only because we received the letter of claim from him

for his own financial reward, but because it was

so obvious by the CCTV footage that he actually slipped on purpose.

Since the evidence was all caught on camera,

it was a foregone conclusion.

The outcome of this particular claim was Mr Delisser

received an initial eight weeks - 56 days - actually onto his sentence,

which he completed.

Although his original sentence and the reason why

he was in prison to start with was quashed, the prison

authorities took a tough stance when it came to his attempted fraud.

It's a message that we do want to, say, take out,

that we don't take this lightly.

Quite the contrary,

the claimant felt the heavy hand of the law again.

The popularity of online shopping means it's a multibillion pound

business, but there's nothing more annoying than ordering something

over the internet and then having to send it back if it isn't right.

That's where the Royal Mail comes in.

They pride themselves on going the extra mile to ensure

items are delivered and returned safely.

So, when something goes wrong, it's a big deal.

When an online shopper got in touch to report that an item they'd

returned by post to an internet jewellery retailer had never

arrived, the Royal Mail's Diane Matthews looked into it.

The customer had returned an item that they purchased online,

which was an engagement ring for £1,900.

And when the package was opened back at the jewellers,

it was found that the ring and the box were not inside the packaging.

The customer was claiming that the ring was in the packet

when he posted it and, therefore,

has been stolen by a member of Royal Mail.

The company takes such an accusation very seriously

and immediately launch investigation.

The customer was asked to fill in a claim report and provide

the team with proof of postage.

Royal Mail received the claim from the customer

and it was forwarded to the investigation team.

And when we looked at it and we looked at the paperwork that was

associated with the claim, then the posting receipt was looked at

and it was noticed that the weight of the item was on there.

The weight corresponded to the weight of the package

containing the ring and the box

when the customer took it to his local post office to send it back.

The weight was to be a key piece of evidence.

Meanwhile, the Royal Mail investigation team contacted

the online jewellers for their side of the story.

The jeweller, when they receive all packages,

weigh the item as well as check the packet for any signs of tampering.

It was established that the package hadn't been tampered

and that the weight of the item was identical to the weight

when the customer posted it at his local post office.

I might not know much about carats - the diamond ones, not the veg -

but I do know they weigh something.

If the two weights were the same,

that means the parcel was empty to start with.

Therefore, the customer had kept hold of the ring.

The case had fraud stamped all over it

and the investigation team paid the customer a visit.

The customer admitted when interviewed that he made

the purchase of the engagement ring purely to facilitate

a fraudulent claim to Royal Mail in order to recoup his £1,900.

We contacted Merseyside Police

and the customer was then arrested on suspicion of fraud.

The case proceeded to court

and justice was delivered for the £1,900 he tried to claim.

He was given a criminal record

and also an 18-month conditional discharge.

He was also ordered to pay back the £1,900 investigation cost

and also a victim surcharge.

But the story didn't end there.

The customer had tried to return the ring to the company

after his scam was exposed, but they refused to accept it.

The customer was handed the ring back as he entered into a finance

agreement to pay for the ring.

In this instance,

the customer has paid twice for the ring, in essence - sort of a

double whammy simply because he has to pay his finance agreement

when he purchased the ring

and he also has to pay Royal Mail £1,900 in compensation and costs.

In this case, the would-be fraudster pushed the envelope too far.

It's satisfying to get a result like this because the Royal Mail

employ a lot of honest individuals

and obviously the fact that their integrity has been questioned

is something that we need to protect.

I think the customer thought that he'd only have to put

the claim in and we'd pay it, but Royal Mail do actively check

compensation claims as a matter of routine.

This claim certainly didn't pay off.

Insurers are taking the fight to the fraudsters using every

tool at their disposal.

A big growth area is in specialist consultants,

like Tara Shelton of i-Cog.

She uses techniques that identify fraud more swiftly than normal.

She's every scammer's worst nightmare,

a former police officer with a degree in psychology.

If you actually mix the key ingredients of my background

in the police with psychology it's, in essence,

given us the perfect, unique mixture

of how to assess claims in a way that

maybe not have been done before.

She can tell if someone is lying just from listening to their voice.

Actually listening to a claimant talk about their claim

is probably the most powerful source you can ever use to detect either

opportunistic or organised fraud because people convey themselves

in a multitude of ways without them actually realising it.

You will get the individuals that are stupid,

you will also get the individuals that don't even think that

an insurer would assess a claim and commonly we will find

that their account of what happened is missing obvious detail.

So another indicator that we currently see is evasive behaviour.

So they will intentionally try and sidestep, they will

intentionally try and change the topic,

they will intentionally try and divert the call handler

away from the discussion at that present time.

Ultimately, a claim always has a story

about something that's happened, an incident,

and for me that's where the key lies in actually assessing

that account of what happened as to whether it's true or not.

Elsewhere, specialist training means call handlers are now able

to read the signs of questionable behaviour.

One such claim came to LV when they received a call

from a customer reporting the theft of his vehicle

and a subsequent crash.

Once again, it was Claire Lunn who looked into the case.

During the initial call,

our claimant's appeared quite hesitant to

give any detail, quite evasive

and displayed certain behaviours and mannerisms

that gave lots of red flags that perhaps this needed

to be looked into a bit further.

The claimant was asked to give a detailed account of what happened.

'Yes.

'Yes.

'Uh-huh.

'Yeah.'

These were very unusual circumstances of a theft and quite bizarre.

So, again, we wanted to make sure

and validate the circumstances had happened as reported to us.

The insurers called the claimant back

to go over his version of events.

Again, his behaviour was strange.

He seemed confused about what had happened.

"Because I crashed into their house?"

I thought he said it was a thief.

I'm no expert, but it sounded like he'd slipped up there.

However, solid evidence was needed,

and a combination of good old-fashioned investigation work

and curtain-twitching locals was the answer.

People who'd witnessed what had actually happened

gave a completely different version of events.

Far from being an innocent victim,

it was clear that the claimant was the villain of the piece.

Furthermore, he was attempting to get a pay-out for damage

that he'd caused.

They saw our claimant get out of the vehicle.

He appeared drunk and then began to get quite aggressive.

The claimant was actually taken to hospital because he'd suffered

from head injuries from being involved in the incident.

Maybe the knock to the head explains why he thought

he was in with a chance of a pay-out.

We now knew that the claimant hadn't been truthful

and we declined his claim.

It's quite remarkable that our claimant thought that he would

get away with this.

There were several witnesses of the incident, but I think he was

hoping that the insurance company wouldn't do thorough investigations.

He was dead wrong.

The insurer's evidence was passed to the police,

who had already launched their own investigation.

His attempt to claim for damage to his car had hit the buffers.

Our claimant was eventually charged with driving whilst impaired

and was given a 22-month driving ban and a suspended sentence.

The claimant not only put himself at risk but others at serious

risk of harm and then made up a story to try and cover his tracks.

Just like the drunk claimant himself,

his story didn't stand up,

and he was left high and dry with no pay-out and a criminal record.

UK insurers have managed to put the brakes on this

type of small-scale motor insurance scam.

But over in America,

fraudsters have driven the stakes to unprecedented heights.

On the face of it, Andy House was living the American dream.

He owned a luxury car dealership in Texas and drove this bad boy -

a 1.75 million supercar,

caught on film by a passing motorist, student Joe Garza.

Pretty sure that's a Lambo, dude.

Wrong. It's a Bugatti Veyron, and only 450 were ever made.

It's one of the rarest and most expensive cars on the planet.

That will be mine one day.

Wrong again, it won't be anyone's.

House's American dream turned into a nightmare when this happened.

-Oh!

-BLEEP.

-Oh!

-BLEEP.

Whilst driving along La Marque Lagoon,

he had a titanic accident,

swerving off the road at high speed and into the water.

Luckily, he made it out alive, none the worse for wear.

The dramatic clip was filmed purely by chance

and has been viewed and shared around the world millions of times.

While Andy received nothing worse than a soaking,

any hopes of repairing his Bugatti Veyron were sunk.

The soggy supercar was totally beyond repair.

Soon after the accident,

specialist contractors were called in to recover the vehicle.

The loss of such a high-profile car made international headlines

and the world's petrolheads demanded an explanation.

House claimed that as he was driving,

his mobile phone had gone off

and he'd been distracted by a passing pelican

which had made him swerve into the lagoon.

He added that he'd left the engine running

because he was being stung by mosquitoes.

The flooded engine meant that the vehicle was totally beyond repair.

But all was not lost.

As a responsible car dealer, House had taken out extensive insurance,

meaning he was in line for a seven-figure compensation pay-out,

having valued the car at 2.2 million -

to you and me, that's £1.5 million.

And everything would have gone swimmingly

if it hadn't been for the social media clip.

At the time, House was unaware that the accident had been filmed,

but during their investigation,

the insurers were quick to find and analyse the video.

They tried to spot the pelican he claimed to have swerved to avoid,

but it's more of a case of

"where's the birdie?" not "watch the birdie."

The pelican is nowhere to be seen.

The clip also shows he made no attempt to brake

before splashing into the lake.

Convinced that he had deliberately trashed his supercar

to get an insurance pay-out, the insurers rejected the claim.

They then reported him to the authorities

and he was eventually put on trial for wire and mail fraud.

In August 2014, he pleaded guilty

and could face up to 20 years in the slammer.

Using his Bugatti Veyron to try and pull a fast one

ultimately left Andy House a washed-up fraudster.