Episode 4 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, stand back. 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.

Coming up, a brickie's personal injury claim

is demolished by the courts.

We've got filming of him carrying out heavy manual labour

with a vibrating plate that's used to actually lay paving stones.

It's ten out of ten for one passenger's attempt

to defraud a bus company.

One thing I would have loved to have seen in this footage

is the other passengers holding up cards with marks on.

I think that would have just made the piece absolutely brilliant.

And the unbelievable lengths some people will go to in order to

cash in on a personal injury claim.

Over 30 million people make up the British workforce,

with around 15% of those self-employed.

But, while being your own boss has its perks,

such as flexible hours and lots of tea breaks,

the biggest drawback is that when you don't work you don't earn.

So injury or illness can have a serious impact on your income.

Someone who knows all about this is bricklayer Paul Havert,

who injured his wrist so badly

that he was forced to hang up his trowel for good.

Fortunately, though, he was covered by an insurance policy that

would pay out in the event of such a disaster.

Richard Davies is Axa's head of fraud.

Paul Havert was claiming for a life-changing sum of money.

You know, he was claiming for loss of earnings totalling £200,000.

He claimed that he couldn't undertake his existing work as a bricklayer,

he claimed that he couldn't do anything

other than very, very light work.

He said, for example,

that he couldn't drive for long periods of time.

Unsurprisingly, no money coming in quickly took its toll

and it wasn't long before Havert was struggling

to keep his head above water.

But, thanks to Axa, he had a lifeline.

He also told us that his mortgage was in arrears

and we immediately made a payment of £30,000 to ensure that

Paul Havert continued to live in his house.

There was no disputing that Havert had suffered a genuine injury.

However, with a potential pay-out of around £200,000,

Axa wanted to double-check the foundation of his claim

before they handed over any more money.

We undertook some surveillance and we didn't expect that to tell us

anything other than Paul Havert was indeed very seriously injured

and couldn't work,

but we saw something completely different.

They certainly did.

And it was at this point that Havert's claim

came crashing down like a tonne of bricks.

He told us that he wasn't able to work in the building trade,

but we can see him working at roof level.

He's picking up what appears to be a pretty long and heavy piece of wood.

Hardly the actions of a man who's unable to work.

We have footage of him driving a van over long periods of time.

Well, taking the van out for a spin doesn't seem to be a problem.

But when they saw the next bit of surveillance,

for a man laid up with a wrist injury,

they couldn't believe their eyes.

We've got filming of him carrying out heavy manual labour

with a vibrating plate that's used to actually lay paving stones,

which suggested that his wrist was nothing like as badly injured

as he said it was.

Havert had been well and truly rumbled...

..so Axa decided to do a bit more digging.

When they looked into his bank account,

it had built up some unexpected figures.

Paul Havert told us that he was earning around £100 a week

between December 2012 and May 2013,

so we expected to see around £2,000 going into that bank account.

That's not what we saw.

We saw £33,000, which Paul Havert didn't explain to us.

Havert had been blatantly lying and, as far as Axa were concerned,

they'd been taken for a ride by a scheming builder

and refused a £200,000 claim.

Once we got the surveillance evidence that Paul Havert wasn't

seriously injured, we chose to defend the claim.

Paul Havert sued us on that basis,

so we had to go to court to defend ourselves.

The court agreed that £40,000 will be enough of a pay-out

from Axa in light of his injury.

But, not wanting to let this criminal get away with it,

Axa brought Havert in front of the judge again

and top of the agenda were his earnings.

When this case got to court, Paul Havert actually admitted

that he'd paid £30,000 into his bank account for manual labour

that he'd undertaken whilst he said he was injured.

As it turned out, it wasn't the damning footage that would get

the better of him, but simply that he'd been economical with the truth.

That meant that the loss of earnings claims wasn't what

he said it was and the judge held that that was a significant lie,

and held him in contempt of court because of that.

In January 2015, at Middlesbrough Crown Court,

Paul Havert pleaded guilty to contempt of court

and received a six-month suspended prison sentence.

During sentencing, the judge said Havert was escaping

jail by "the merest whisker."

When somebody chooses to lie to us in this way,

it must mean that they're either desperate to make money or they

just think it's acceptable to take money that they're not entitled to.

Havert's claim was settled at £40,000.

As he had already received 30,000 during the early days

of the claim, there was still 10,000 outstanding,

but this criminal still didn't end up with it in his back pocket.

The £10,000, which the judge ordered he should be paid,

was paid into a safe quart account,

so it's not money he actually received.

And, secondly, he was ordered to repay our costs which were,

at the end of the case, far larger than that £10,000.

So much for a dodgy wrist,

think it's more of a slapped wrist now, sunshine.

Still to come, a new driver falls victim to a crash for cash scam.

I had a few nightmares about it, like, what's actually happened?

I thought it could have been my life, at the end of the day

if I was going any faster.

And a dream trip to South America turns into a nightmare.

For such a serious incident such as a kidnapping,

you would think that the customer would want to speak with someone

straight away to see how we can help him or something like that.

With millions of vehicles on the UK's roads each day,

the traffic in city centres can be chaos and accidents are inevitable,

but the claims team at First Group found themselves dealing

with one case that seem to be more of a practical joke.

We received a claim for an incident that had allegedly

happened on the 1st April 2014, where it was said that the bus had hit

a vehicle in front and the claimant had been

thrown to the floor as a result of this collision.

Fortunately for First Group, every one of their buses is fitted

with more cameras than a paparazzi kitbag.

So, let's take a look at this accident.

Did you see it? No, me neither.

Let's take another look.

Right, here it comes.

I'm still not seeing it.

But for one passenger, this was a truly brutal collision.

When the injuries actually came in,

they were, allegedly, broken teeth, possible fractured ribs.

Anyone who's sort of broken a rib or suffered that sort of injury

will know just how painful that can be. It does really hurt.

With such painful injuries, a costly claim was at stake.

We would expect a claim of this nature to be around about £12,000.

This would cover compensation for the injury itself and also

there would have been an element, possibly, for some lost earnings.

You would need a little bit of time off work, depending on what you did.

There would be dental treatment costs.

Potential physiotherapy fees for the neck and the soft tissue injuries.

Due to the extent of the injuries,

First Group started to investigate how the bus was being driven.

Besides having CCTV cameras inside and outside of the bus,

they also have another trick up their sleeves.

All of our buses are fitted with telematic equipment,

which reads any signs of adverse movement within the bus.

So, if the bus brakes too hard,

corners too hard or accelerates too quickly,

we will get a recording within the bus to suggest that the driver

may want to alter the way he's driving the bus.

And these are the sorts of things we're looking for

when we see claims of this nature coming in.

Yep, you guessed it.

The telematics on the bus told a completely different story

to that of the claimant.

There was no evidence that any adverse movement had actually

occurred and this would mean that one of our potential fraud

indicators had just been tripped.

Feeling there might have been a slip up, Lee looked at the bus's CCTV.

We're looking to see what happens to the people around the claimant.

It's not so much what they do as to what they don't do.

The chap in front holding the coffee doesn't even know anything's

happened till he hits the floor at his feet.

Let's have another look.

Watch your coffee, mate,

the bloke behind seems to be heading for a fall.

In fact, for Lee, this would be great on the big screen.

I could watch this again and again, all day long.

His actions are comical. The way he suddenly flies forward.

No-one else moves, it's amazing.

And looking at it from the rear, yep...

..bit of a nosedive there.

This potential fraudster had well and truly fallen flat on his face.

He might have been looking for an opportunity to either put

himself in a position where he could make a claim,

or to further his acting career in the circumstances we've got here

because it's a brilliant manoeuvre that he undertakes

to throw himself to the floor. Fantastic.

Nonetheless, the claimant's acrobatic skills never cease

to bring a smile to Lee's face.

One thing I would've loved to have seen in this footage

is the other passengers holding up cards with marks on.

I think that would have just made the piece absolutely brilliant.

This claimant had clearly been trying it on.

As far as we were concerned,

this claim just couldn't have happened the way he'd said.

Bear in mind, this happened on April Fools' Day.

The biggest joke here is this chap's pathetic attempt

at trying to defraud us.

On this occasion, for the claimant, it was a case of nil points.

If you think our bloke on the bus's attempts to cash in was extreme,

then brace yourselves because, in other parts of the world,

there are people who will go to jaw-dropping lengths

in order to cash in on an insurance pay-out.

Now, driving abroad can be a daunting prospect.

Unfamiliar road signs, locals who think they're Lewis Hamilton

and being on the wrong side of the road are just some of the things

you need to contend with. But, as these next clips show,

they aren't the only things that you've got to dodge.

I know this looks awful, but let's rewind a little.

Is he running towards a moving car?

A genuine personal injury claim could be kerching.

But with playacting as pathetic as this,

all this lad's earned himself is a proper rollicking

from the driver, who tells him in no uncertain terms to get lost.

"Go on, pavement's over there."

Maybe next time, this young man will think twice before

he throws himself on the bonnet of a moving car.

As staged personal injury claims go, that was a pretty pitiful attempt

and sometimes it takes a man to show you how it's really done.

Now, how dangerous could driving around a Korean car park be?

Not dangerous at all, you say? Think again.

Yep, that's another potty pedestrian running towards a moving car,

only this fellow really means business.

SCREAMING

And one for luck. That should do it.

On the replay, this one's even worse.

More of a method actor.

This chap leaves nothing to chance.

Yep, when it comes to driving,

some people gear themselves up to try and green light a pay-out.

From taking a dive into the path of moving traffic,

to bouncing off bonnets and bumpers...

..and suicidal cycling.

But there are those whose attempts tend to stall.

I've got to see that again.

This guy's effort has definitely fallen by the wayside.

But this has to be one of the most useless attempts I've seen.

She can't even be bothered running at the car.

Some people will do anything for a lift home.

Seriously, playing dead isn't going to get this woman anywhere.

Come on, get up and go home.

But, for any potential fraudsters out there who think this is

an easy scam to a fast bit of cash,

beware because sometimes you can wind up the wrong driver.

Clearly not a fan of personal injury opportunists,

this driver's taken the law into his own hands

and is dishing out a bit of justice of his own.

Never mind swapping details, this fellow might have been

better off if he'd really been hit by the car.

Crash for cash is becoming a major policing issue.

Cars working together to cause deliberate accidents are milking

the insurance industry out of just over £390 million a year.

Crash for cash starts

when one or two cars move in front of the victim.

The first car brakes, giving the second car a reason

to come to an abrupt halt...

..causing the victim's car to go into the back of them.

The driver of the car that's been hit can then

cash in on a hefty insurance pay-out.

Staged accidents like this have become a serious social problem,

but it isn't just the insurance companies who are the victims.

Reports suggest that one in seven personal injury claims

are linked to deliberate crashes.

People are getting seriously hurt.

With crash for cash crime on the rise, the police will use

everything in their power to bring these criminals to justice.

Passing your test and having your first car is an exciting time for everyone.

But for Tom Griffiths, this all turned a bit sour

when he was caught up in it crash for cash scam in March of 2012.

I thought it was all my fault, like, I've driven into the back of someone.

Why would I do that? How can I drive again?

If I've done this before, I can do it again.

I had a few nightmares about it, like, what's actually happened?

I thought it could have been my life, at the end of the day,

if I was going any faster.

With this being Tom's first accident since passing his test,

he remembers it like it was yesterday.

After the incident happened, we pulled over to the side

and I've got out of the car and I've looked over,

and I've seen the woman and man swap over in the front two seats.

But the fraudsters didn't stop there at trying to trick their victim.

They've asked me to write my details down, so I've started doing that.

And just as I was getting my name down, they've brought

a sheet of paper with all their details before I've even wrote

anything on the piece of paper.

I'd wondered why they've done it so quickly -

how they would have known to have done that straight away.

Although in shock, Tom still had his wits about him.

I phoned my dad up and I said that he was on his way,

and they've all really hurried up and they've all ran into the car.

No injuries or anything,

they just ran in and they've just drove off straight away.

For Tom's father, things didn't add up.

Suspecting a possible crash for cash scam,

he alerted the Metropolitan police,

where DC Roger Crawley took up the investigation.

Mr Griffiths senior had seen a lot of publicity in the press,

and therefore he thought that this was an induced collision

and that the police should investigate it.

We get information from all sorts of sources

but, in those particular circumstances, to get a phone call

from a father of a young man, I haven't had it before.

And Roger wasted no time in getting to the bottom of what had happened.

There were two vehicles in front of the victim's car.

They were going round the roundabout.

It looks as if both cars were committed to the exit.

The front car suddenly swerved back onto the roundabout

and shot off towards High Wycombe.

The second vehicle slammed on its brakes and, unfortunately,

Tom Griffiths, who was behind, wasn't able to brake in time

and collided with the rear of the second vehicle.

As Roger carried out his enquiries,

it appeared that Tom's family's suspicions might be right.

The male told him that he was the driver,

but subsequently a note was handed to Tom Griffiths

with details of Zanbi Mirza on it,

and the claim was that she was the driver.

As the investigation continued,

the police turn their attention to the other vehicle

involved in the collision and the people at the scene.

I found out that the vehicle had only been registered

in Zanbi Mirza's name for 12 days prior to the accident

and the insurance had only been taken out four days earlier,

both in her name and Mohammed Khalid's.

I was immediately suspicious of the circumstances

and, from previous experience, this is indicative of, perhaps,

that it could be an induced collision.

With the odds stacked against them,

they were brought in for questioning.

First up was Mirza.

When I interviewed her, she denied any knowledge of the accident.

She denied she'd had any contact with Khalid.

She denied knowing him in any shape or form.

However, Khalid had a completely different story.

He told me that his daughter was best friends with Zanib Mirza

and they went to college together,

which totally threw everything that she'd said.

Khalid also denied even being at the scene of the collision,

but Roger has a vital piece of evidence that well and truly blew

that defence right out of the water.

There was a note that was handed by the person

that purported to be the driver to Tom Griffiths.

I subsequently had that forensically examined

and I was able to prove that Mohammed Khalid must have handled that note,

and therefore he must have been there at the time of the collision.

With all evidence pointing toward them,

the fraudsters appeared at Southwark Crown Court

and pleaded guilty to conspiracy to defraud.

Mohammed Khalid was sentenced to ten months in prison.

Zanib Mirza received 240 hours community service.

The downfall was the forensic evidence, ultimately,

and the fact that Tom Griffiths' father

took it on himself to come to the police,

and asked me to take up the mantle of investigating it,

which we did and, obviously, then we were able

to get the conviction at court.

It's estimated that the cost of these fraudsters' con

was going to be in the region of £10,000,

but it doesn't just put a dent in the insurer's pockets.

When it comes to car insurance, for young, inexperienced drivers,

it's an expensive game, with cover costing, on average, over £1,000.

Well, Tom Griffiths was only 19 years old and, as anyone would know,

19-year-olds pay a huge amount in insurance.

If they have an insurance claim,

that premium is going to go up enormously, therefore,

it's very unfair on somebody of that age to have to pay

increased premiums for something that really wasn't their fault.

News of the conviction has helped Tom to move on.

The fact that they have faced justice now,

I can go out and live my life. I can drive normally.

I feel like I was just the unfortunate one

in the wrong place at the wrong time, really.

I couldn't have done anything else in what happened.

Jetting off to South America to go backpacking

sounds like a once-in-a-lifetime trip for most people.

Taking in the sights and sounds of Venezuela would be a dream...

..but sometimes the dream can turn sour.

Fortunately, Simon Cooke from CEGA was on hand

when one tourist trip turned into the holiday from hell.

A customer told us he had been robbed at gunpoint

and kidnapped in Venezuela.

We take reports of kidnappings

and robberies at gunpoint extremely seriously

because this could be an entirely genuine claim.

However, in the midst of this crisis, the claimant

didn't approach the insurer in the usual fashion, but via e-mail.

The e-mail was quite strange because in the subject line

the customer had written, "Urgent!", with exclamation marks,

And then, in the body of the e-mail,

had stated that he been kidnapped and robbed.

From the start, the customer's behaviour was cause for concern.

We didn't understand why he wouldn't have just picked up the phone and called us.

For such a serious incident such as a kidnapping,

you would think that the customer would want to speak with

someone straight away, to see how we can help him,

give him some advice on,

to go and see the consulate or something like that.

Considering it was such a traumatic experience,

the claimant's actions were suspicious enough...

..but the items he was claiming for just didn't make any sense.

The £8,000 claimed was for all manner of designer clothing,

fishing equipment.

A fishing rod? He obviously thought CEGA

were going to fall for this, hook, line and sinker.

He had also claimed 1,000 for personal care,

which we just didn't understand what that was for.

Personal care? I don't either, mate.

But it seems like this potential fraudster

had intentions of being the best dressed backpacker in town.

It's quite unusual for your average backpacker to be carrying around

£3,000 worth of designer clothing as they trek around South America.

Suits you, sir! But it wasn't just the claimant's dapper dress sense

that set off alarm bells.

It's extremely unusual for someone to take out insurance cover

solely for personal possessions,

especially if they're backpacking around South America.

You would expect them to also take out medical cover.

Whilst the customer is entitled to take out whatever cover

they feel is appropriate,

we certainly think it's a bit of a red flag if a customer who's

backpacking round South America wouldn't take out medical insurance.

Since it had been such a serious incident, the insurer thought

there would be something in the media,

but their search threw up nothing.

The police report made absolutely no mention

that the customer had been kidnapped, which is extremely unusual,

as we see many police reports from all over the world,

and something as serious as this, whether it's in Venezuela

or the UK, would be listed on the police report.

When the claimant submitted his travel documents,

he failed to get off to a flying start.

We noted there were several irregularities

in the booking invoice that he'd provided.

Firstly, the airline flight number didn't relate to the said airline.

We also noted the airline didn't even operate a route

that was shown on the booking invoice, which was very strange.

And one of the internal flights was eight hours prior to him

even arriving in the USA.

Yes, pointing out that you hadn't even

landed in the US at the time was definitely a slip-up.

We were not happy that this was a genuine booking invoice, at this point.

No matter how many times the claimer tried,

he just couldn't seem to get his claim off the ground.

We challenged the customer with the irregularities

and he told us that he had provided us the wrong booking invoice.

He then subsequently provided us with another booking invoice

and again there were more irregularities within that,

because it showed that the booking

was six months prior to him even taking out the policy.

To CEGA, it was obvious that this potential fraudster had been

looking for the sympathy vote.

By reporting a kidnapping at gunpoint, I believe the customer

thought that we would have more sympathy

towards the circumstances that he's presented,

when, in fact, that actually just raises more alarm bells.

But the insurer wasn't going to be held to ransom.

The fact that the customer provided us with a false booking invoice

does cast serious doubts as to whether the kidnapping even occurred.

For CEGA, this was a case of hands up.

This wasn't a well thought out fraud at all.

Unsurprisingly, we haven't heard anything

further from the customer since we rejected the claim.

He certainly wasn't a master criminal.