Episode 2 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 of the vehicle.

..sophisticated data analysis techniques...

..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.

Badly forged documents mean a life insurance fraudster

is caught red-handed.

And I just thought it's, you know, bang to rights,

his fingerprints on his cremation certificate.

A video posted online

cracks the case of a fake claim against Newcastle City Council.

Yeah, he WAS seriously injured and so he was off work.

That was through no fault of the local council.

That was through his own stupidity.

And a personal injury claim goes up in smoke.

He gave the impression that he was generally pretty squeaky-clean.

But, in fact, the social networking evidence that we had

showed that he lived a different life altogether.

'..please contact the information' desk.

For most people,

the worst thing that might happen on a family holiday

is missing luggage, sunburn

or overindulging on the all-you-can-eat buffet.

But for the Sanchez family from Surrey,

the unthinkable happened.

On a family break to Hugo Sanchez's home country of Ecuador,

he suffered a fatal heart attack.

His devastated wife flew back to the UK to make arrangements.

No simple task, as Mr Sanchez had created a web of complex finances.

These were untangled by DC Jacqui Bartlett from Thames Valley Police.

He'd taken out a number of life insurance policies

prior to his death.

From his employer, HMV, he was entitled,

or his family were entitled to a death benefit of £112,000.

He'd taken out a policy for £500,000 with Legal & General.

With Liverpool Victoria, he'd taken out a policy for £117,000.

And there were numerous other small loans

that had been taken out before his death.

The grand total of the money was £847,000.

Mrs Sanchez stood to benefit from an astronomical amount of money

and the claim was finely scrutinised.

The insurers who looked into the claim

were suspicious from the outset

because of the large amount of life insurance, or assurance,

that was taken out prior to his death in 2004.

So, that was a red flag warning to them that this could be suspicious.

With hindsight,

Hugo Sanchez's behaviour at work before he left rang alarm bells.

HMV understood

that he was going on holiday to Ecuador to see his family.

And it was only retrospectively when they got the report that he'd died

that they realised his desk had been cleared

and all his family photos had been taken.

And they thought, "Mm, that's a bit strange."

Was this a grave mistake

or was it a sign that all was not as it appeared?

Soon afterwards, another wrong note was struck.

One of Mr Sanchez's friends had been left with a discount card

and he decided to use it to buy some Elvis CDs,

and he was stopped by security

who were questioning why he was using a dead man's discount card.

And he said, "Well, he's not dead.

"He left it with me, I have his permission."

And he went on to phone Mr Sanchez and the call connected,

but then Mr Sanchez put the phone down.

It was now a case of suspicious minds.

Serious doubts were creeping in

about whether Hugo Sanchez had actually died

and insurers appointed an investigator.

The findings of the report were that they believed him to be alive

and this was confirmed by Mr Sanchez's wife's family

who lived in the UK, because they had not been...

They were not part of the plot. They had not been told that he was dead.

They said, "No, he's alive, they've emigrated to Costa Rica."

It was now clear that he hadn't passed on.

He was just trying to pass the buck.

Mr Sanchez's supposed death was kept secret from his friends and family.

Only his employers and insurers had been informed

and they weren't happy.

HMV had written to the family in Costa Rica

asking for the money back and they'd never got a response.

So, after making enquiries with the Ecuadorian consulate

and obtaining some information, they reported it to Thames Valley Police.

From there, the case landed on Jacqui's desk.

Her first move was to establish the true sequence

of events and locations.

Hugo Sanchez had attempted to cover his tracks

by moving from country to country.

He'd died, apparently, in Ecuador,

but the family had emigrated to Costa Rica.

But then from Costa Rica, they'd gone to Australia.

He was down under, rather than six feet under.

Jacqui also focused on the documentation that had been provided

to support the claim.

The cremation certificate that we got from Mrs Sanchez's solicitors

was put in for forensic testing and revealed Mr Sanchez's fingerprint.

I presumed the system in Ecuador was the same as ours,

that the cremation certificate is issued after the cremation.

So, it would be impossible for him

to have any rational explanation for a fingerprint on it.

And I just thought it's, you know, bang to rights,

his fingerprints on his cremation certificate.

Despite the schoolboy error,

this was much more than an opportunistic fraud.

Jacqui discovered that Hugo Sanchez had more than one identity.

He had also used his brother Alfredo's name.

Mr and Mrs Sanchez had got married in Ecuador

and he used his brother's name to marry his wife.

And then when he came to the UK, he came here as Alfredo Sanchez

and got a British passport in that name.

But then a couple of years later, he changed his name by deed poll

and got a passport in the name of Hugo Jose Sanchez

and then married his wife again, her using her maiden name, in the UK.

The dual identity was very useful, because he died as Alfredo Sanchez

and that passport was provided by his wife to the insurance companies.

And then he went off to live in Australia

using the name Hugo Sanchez.

By this stage,

Jacqui had collected enough evidence to move in on the undead fraudster.

Her chance came when there was a family wedding in the UK

and Mrs Sanchez made the journey over to attend.

I don't know why she did that.

Maybe they thought, "Well, nothing's happened. I'll come back.

"It's been a couple of years, it'll all be fine."

But it wasn't fine, because she was detained at Heathrow Airport.

And then she was transported back to Thames Valley Police

where myself and my sergeant interviewed her.

If I hadn't already planned the interview and had it all ready,

I'd have been, "Uh!"

because there was so much information to put to her.

But Jacqui had done her homework and it paid off.

She accepted her husband was alive

and then when we talked about the insurance claims,

she just started to answer, "No comment."

Mr Sanchez, meanwhile, was in Australia with the family,

and that was the next stage, to apply for his extradition.

With the assistance of the Australian authorities,

eventually, he was brought back to the UK

to face the music in a court of law.

Mr Sanchez pleaded guilty to all 12 charges

and then he was sentenced to five years.

Mrs Sanchez was sentenced to two years.

Sanchez had been caught red-handed.

And the former record company employee

was now doing the jailhouse rock.

MUSIC: Jailhouse Rock by Elvis Presley.

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 deal with a wide variety of insurance fraud offences,

from serious crash for cash to household fraudulent claims.

We are responsible for bringing insurance fraudsters to justice.

They've made over 660 arrests

and have saved millions of pounds in fraudulent insurance claims.

Money which, ultimately, goes back into our pockets.

From now on, fraudsters need to watch their backs.

Insurance fraud isn't a victimless crime.

If you are committing insurance fraud in England and Wales, we'll find you.

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

And it's not just the insurance industry

that's working in partnership with IFED.

Councils around the UK are also joining forces

with the elite police department to crack down on fraud.

Councillor Veronica Dunn is from Newcastle City Council.

We take out an insurance policy

to cover us against claims

for things like personal injury or public liability claims.

In 2012, floods swept through the North of England,

seriously affecting Newcastle and the surrounding areas.

Council employees worked hard to deal with the floodwaters

and make the city safe.

But soon afterwards,

a claim for personal injury was submitted by Stephen Robinson.

Scott Clayton from the council's insurer, Zurich,

provided advice on the case.

Stephen Robinson was walking along the street

and claimed that he had stepped in a flooded manhole cover

and injured his ankle.

It was quite a severe injury that he was claiming for.

On the surface, his tale of watery woe seemed genuine.

On that particular day, Newcastle, with other parts of the country,

did, in fact, sustain severe flooding.

There was no doubt in the council's mind

that an injury had been sustained.

The question was, who was responsible?

The answer was found by surfing the web.

The council received a tip-off about a video posted onto social media

that had made quite a splash, clocking up thousands of views.

It was passed to the police and viewed by IFED's DC Kate Sibley.

INDISTINCT SPEECH

He takes a running leap from the pathway.

Takes a couple of steps and then falls over.

And, as you can see, he then lifts his left leg out

and his foot is facing the wrong way.

-I've snapped my ankle.

-What did he say again?

When I saw the video clip, I did feel quite angry.

It's obvious that, under the circumstances,

this was not an injury that was caused

as a result of the council's negligence,

but was caused directly by Mr Robinson's own actions.

That's not something that the council-tax-payers in Newcastle

should be paying for.

This was a case that we undoubtedly wanted to prosecute,

because it's local council money, and had we not had this footage

or established what exactly had happened

then that money would potentially have been paid out to him.

The council and IFED were determined to put out a strong message

that they weren't going to tolerate this kind of fraud.

Still to come, the failed fraudster

attempts to give DC Kate Sibley the runaround.

We will get hold of him somehow. I won't give up.

And a claimant tries to bully his way into a pay-out

he doesn't deserve.

These days, social media is everywhere.

Who hasn't been tagged in an embarrassing photo?

And it's not just friends and family

who might be following your online activities.

It's insurers, too.

In September 2012, insurers AXA

were presented with a personal injury claim from Daniel Brownfoot.

He'd been a passenger in a road traffic collision

involving a driver who was an AXA customer.

Brownfoot was being given a lift to a DIY store

when a pit stop landed both him and the driver in trouble.

Tara McSorley is a solicitor with BLM, the insurer's lawyers.

The driver pulled in at the side of a residential street

and produced a carrier bag full of cannabis.

The driver rolled a joint and began to smoke it.

The claimant refused to take any of the cannabis.

At that point, quite incredibly,

the police drove past and smelt the cannabis.

I understand that this cannabis has a very pungent odour.

The driver then drove away at speed with the police in chase.

But he lost control of the car

and smashed into a bollard on the passenger side.

The claimant refused to go to hospital by ambulance

and the police took them both to the police station.

The claimant was examined at the police station

to be sure that he was fit for interview.

So, Brownfoot appeared to have come out of the accident,

in which he'd been a passenger, none the worse for wear.

A few months later, AXA received a letter of claim

indicating that he was going to claim for a personal injury.

The claim detailed a range of soft tissue whiplash-type injuries.

He was claiming for injuries to his neck, upper back,

left shoulder and an injury to his left thigh.

We would have expected compensation to be paid

in the sum of around perhaps £4,000 to £6,000.

It was a huge amount of money

for injuries that apparently hadn't existed

when he'd been examined at the police station.

And the insurers were keen to weed out any irregularities.

The concerns generally stemmed from the fact

that drugs were involved in this accident.

There were investigations carried out into this claimant.

And so we went looking for him online.

And they found him,

together with evidence of the type of life he was leading.

He gave the impression that he was generally pretty squeaky-clean.

But, in fact, the social networking evidence that we had

showed that he led a different life altogether.

He followed a number of sites

which purported to support the use of drugs.

The investigation also raised questions

about the severity of his alleged injuries.

So, this accident happened at the start of September

and a number of days after this,

the plaintiff had posted a photograph

where he was shown to have both legs suspended

either side of a very large tree branch.

I mean, if you're suffering from soft tissue injuries

to the extent that the plaintiff claimed,

you simply wouldn't be able to have climbed the tree.

And in another of the images, he was dressed up like a hot-dog,

drinking and smoking and having a good time.

What a silly sausage!

Despite the suspected drug-taking

and the police chase in which Brownfoot had been a passenger,

the claimant and his solicitors had the front

to pursue the case in court.

There, he was cross-examined about the tree photo.

He said that the branch and the tree were supporting his back,

which was just nonsense.

He was also asked to explain a comment he'd posted on a site

featuring a photo of drug use.

He said that the reason that he had picked this particular image

was because he had done a photography course and that he thought

that this was a particularly well photoshopped image.

All in all, he'd made a hash of the questioning,

but there was more to come from the lawyers.

So, the second prong of our defence

was the fact that this was a joint criminal enterprise.

We were saying that, basically, the claimant was in on it

and he knew well that drugs were in the car.

What happened next must have driven Brownfoot potty.

The court dismissed the claimant's claim.

This claim was never one that AXA would have paid.

There were too many concerns

about the fact this was a crash that had happened

where there were drugs on board

and where there had been a police pursuit.

Brownfoot's social media profile earned him a #fail

as he watched his personal injury claim go up in smoke.

In the last few years,

fraud detection has become increasingly sophisticated.

Insurers are now turning to specialist consultants

like Tara Shelton of i-Cog.

Combining her background as a police officer

and with a degree in psychology, she has developed techniques

that identify fraud more swiftly than normal.

It's quite sad to say,

but I think the majority of the population that do make claims

that are exaggerated or are fraudulent

do think that insurers are there for easy pickings

and that it's almost their right to make a claim.

But fraudsters have met their match in Tara.

A phone call is all she needs to tell if they're lying.

What I would class as one of the extreme indicators

is something that I call sabotaging behaviour.

So, that's when the claimant reacts

in an extremely disproportionate manner

because, for example, they don't like the information they've been told

or they believe there is now an obstacle in their way

to obtaining the money that they're after.

In other words, they're seeking to sabotage the process

and threaten or pressurise the claims handler to make a pay-out.

The latest figures show that violent crime

has been steadily falling for the last 20 years.

So, to be mugged multiple times in a period of months

starts to look more than just unlucky,

especially when you factor in other losses.

Neil McFarlane is the managing director of TH March & Co,

a company that provides specialist insurance for jewellery.

They were contacted by a claimant

who went on to become something of a regular fixture.

The first time we heard from this customer

was for the loss of a couple of stones

out of his fiancee's engagement ring.

This is quite a common occurrence, nothing particularly usual,

and the amount involved was only £125

and that claim was quickly settled.

But it wasn't long before fate dealt another cruel blow to the claimant.

He notified us that he had been attacked in his car

and had a gent's watch stolen

together with his wallet and his mobile phone.

Being contacted so soon after the original claim,

this did put us on a bit of guard.

But there was nothing particularly unusual

in the circumstances of the loss.

The watch had been a distinctive Cartier Santos model,

meaning the claim was worth several thousand pounds.

Then, against all the odds,

the customer was targeted once more with a knife-point mugging

that robbed him of an expensive ring worth £2,500.

Being mugged twice within six months is very, very unusual.

I know many people who've never been mugged in their entire lives.

To be mugged twice in six months does mean he's either very unlucky

or he's considering a fraudulent claim.

With that in mind, it was decided that a loss adjuster

needed to be brought in to look at the claim.

The news was greeted less than warmly.

When he realised that getting his claim through

wasn't a simple matter of filling in a form,

the claimant's manner changed towards the call handler.

He became very aggressive, very defensive,

did not want to meet with the loss adjuster.

He also made certain allegations against members of staff

which were completely unfounded

and I think were used as a smokescreen.

After the phone call,

another member of the TH March staff spoke to the claimant.

Once again, he appeared to try and sabotage the process.

Did I hear that right? He's going to cancel his policy?

That effectively means

that he's not going to pursue the claim for the ring,

which apparently was stolen from him.

He's walking away from a potential settlement of £2,500.

When somebody's not really interested

in wanting to progress the claim

and complaining that a loss adjuster's been appointed,

we think that's a bit too defensive

and points to the fact that it may not be a genuine claim.

Unsurprisingly, they heard nothing more.

Until two years later, they were contacted about another claim.

The name seemed very familiar to our claims handler.

And upon taking details, including mobile phone number, e-mail address

and the actual items stolen, it was pretty much all identical.

A loss adjuster was quickly appointed to handle the case

and the claimant was informed.

Two years later, this is his response.

Hold on.

That sounds suspiciously similar to his strategy from two years ago.

Change the record. It's the same sabotaging tactics all over again.

In addition, the make and model of watch

was the same as on the second claim - a Cartier Santos.

But what really set alarm bells ringing was when it became clear

that the serial numbers of the two watches were sequential.

Going by the losses were over two years apart,

the chances happening are very, very slight indeed.

Once again, he wanted to just basically cancel his policy cover.

If you couple this with the previous loss for a ring of £2,500,

he's potentially walking away

from claims totalling in excess of £6,500.

In our minds, this is highly suspicious

and is a good indication of a potential fraudulent claim.

Time ticked away and the claim, like the missing watches,

disappeared for good

and they never heard anything more from the man.

After flash floods hit the Northeast in 2012,

Newcastle City Council was contacted by Stephen Robinson,

a local man who claimed that he'd broken his ankle

as a result of a poorly maintained manhole cover.

But social media pulled the plug on his fraudulent claim.

It was clearly a self-inflicted injury.

I've snapped my ankle.

So, DC Kate Sibley went after him IFED-style.

We're planning to knock on his door and make the arrest

and take him back to the local police station,

where we'll interview him, put the evidence we have to him

and see what he's got to say for himself.

You get a buzz when you're arresting somebody

and the adrenaline does pump,

because you want to get the perpetrator.

You've worked hard on the investigation

and you want to see it come to a conclusion.

Kate and her colleague, DS Mark Forster,

started at the last known address for Stephen Robinson.

Just want to go round the back.

KNOCKING

Morning. City of London Police. Is Stephen about?

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

This is his parents' address. He's not at his parents' address.

He's moved out about a year ago.

Since moving out, he'd had very little contact with his parents.

They knew nothing about the personal injury claim.

Undeterred, Mark attempted to make contact with the suspect

over the phone.

I'm up in Newcastle with some colleagues

and we need to interview you.

But, again, drew a blank when it went to voicemail.

We can only do what we can do.

We will get hold of him somehow. I won't give up.

While they waited for the suspect to get back to them,

the IFED team stumbled upon the location of the notorious incident.

We believe this is possibly where he's jumped from,

looking at the area and remembering from the YouTube footage.

People were standing sort of either side

and he's taken a running jump down here and jumped off the steps.

If he knows the area, he must have realised it wasn't that deep.

Just a little bit stupid. Not even a little bit - very stupid.

Eventually, Kate's persistence paid off

when she received a call from a blocked number.

Hello, Kate Sibley.

..Oh, yes, I am. Mr Robinson, where are you?

Yeah, it's in relation to an insurance fraud.

Your leg.

All right, OK, I'll speak to you in half an hour.

-He's just phoned me.

-Has he?

-Yeah.

"I believe you're looking for me." "Yes, I am."

"Give me half an hour, I'll phone you back and meet you."

"Where are you?" "I'm not telling you that."

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

but he's going to get lifted at the nick.

-He's probably going to get a brief sorted.

-Yeah.

It's just time-wasting, really.

A bit frustrating, because we're doing as he bids, really,

which I don't like doing.

This is the game we play.

Robinson's solicitor later rang back on his behalf

and arranged for his client to meet the IFED team

at a local police station.

He's on his way, so we've got our man eventually.

We've got all the evidence to put to him,

so it's just what he says in interview, really.

After the arrest and interview, the case eventually proceeded to court.

Unbelievably, he still maintained his innocence.

He went not guilty the first few hearings at court.

Then we went to trial.

We were supposed to have a trial in January of this year, 2015,

and on the day of the trial, he pleaded guilty.

Clearly, he decided he didn't have a leg to stand on.

He was sentenced to 200 hours of unpaid work and costs of £600.

I think he was stupid.

I think he thought he was going to make some easy money.

Yeah, he WAS seriously injured and so he was off work,

but that was through no fault of the local council.

That was through his own stupidity.

So, I don't think he'll be doing it again.

We are the custodians of public money.

The fact is, we need our money to spend on services

to the most vulnerable and to older people and children in our community.

And we don't want that money to be going into a fraudster's pocket.