Episode 5 Claimed and Shamed

Insurance fraud in the UK has hit epidemic levels.

It is 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...

Subject out the vehicle.

..sophisticated data analysis techniques...

Police!

..and a number of highly skilled police units.

Police! Stay where you are.

They are 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 sports car's antifraud technology

puts the brakes on a fraudster's lie.

A drinker attempts to make a claim

despite CCTV knocking back their story.

The response we received back was that they were proceeding with the claim, we were shocked.

How you can even suggest that that was a genuine claim was beyond Weatherspoons.

And how this seemingly innocent hot-dog purchase

is connected to a notorious fraud ring.

With over 400,000 cars written off every year,

drivers can be left stranded if they don't have replacement wheels.

That's where credit hire companies come in.

Neil Thomas is the director of investigation services at APU.

What happens with credit hires

is if the motorist is involved in a non-fault accident,

they are entitled in law to a replacement, like-for-like car.

So, if another driver damages your car in an accident

that's their fault, the insurers will go to a credit hire company

to source a hire car for you.

Accident Exchange is a UK-wide credit hire company

that specialises in the luxury end of the market.

They have in excess of 2,000 top-of-the-range cars.

We are talking Bentleys, Ferraris, Audi R8s -

mainly the prestige side of the business.

Probably worth in excess of £50 million worth of vehicles.

The fleet of mind-blowing motors

is a fraudster's dream.

So Accident Exchange has developed its own high security technology.

Neil recently investigated a case that was jump-started

by the car's on-board security device.

It all began innocently enough.

Mr Kenton came into Accident Exchange

because he'd had a genuine accident. His car was damaged,

he's entitled in law to a like-for-like replacement.

That is what he got - an Audi TT convertible.

But soon after taking delivery of the replacement car,

Kenton rang Accident Exchange to report that disaster had struck again.

He said on the phone call that the car had been stolen.

The Accident Exchange claims handler

asked Mr Kenton for his take on how the car could have been stolen.

No easy task with the vehicle's high security features.

Mr Kenton thought that the keys had dropped from his tool box

when he went into the house and he presumed that somebody

had picked up the keys and stolen the car with the keys.

When we looked at the explanation given by the client,

it was clear that something wasn't right.

At this stage, they weren't sure what.

Luckily, the enhanced security technology will reveal all

and the team called Mr Kenton to let him know.

Was he putting on a front?

Or was he genuinely pleased to hear about the tracker?

The on-board technology, known as telematics, was about to uncover the truth.

Telematics device takes the data directly from the car.

It's almost like a black box inside an aeroplane.

You can capture a lot of useful data,

how the vehicle is performing.

And critically where and when it is being driven.

Using the telematics info,

Neil was able to accurately track the car's location

throughout the night in question.

He'd done a number of journeys.

The vehicle had been filled up with fuel at a petrol station.

The refuelling happened

some hours after Mr Kenton said he'd last used the car,

which meant crucially that the petrol station's CCTV cameras

would reveal the identity of the thief.

Looking at the CCTV, we can clearly see the Audi TT

driving up to the petrol pump

and we can even see that the roof is down,

which is good from CCTV evidence point of view.

Interestingly, when the driver gets out of the vehicle,

it's not the thief, it's Mr Kenton. This is a key bit of evidence.

Far from supporting Mr Kenton's story,

the CCTV blew it apart. The car had been in his possession all along.

He had been caught lying about the car being stolen

and further analysis of the telematics data

revealed that's not all he had been up to that night.

From there, it had been driven round again and at about 4:30 in the morning

it had been involved in a serious collision.

The speeds we are talking about are probably in excess of 90mph

prior to the collision. The collision itself was at approximately 66mph.

The vehicle has hit a number of stationary vehicles.

He is lucky not to be injured.

He ran off from the scene.

There are a number of innocent motorists there

that have had their cars damaged.

He had been speeding, smashed into multiple vehicles

and then left the scene of the accident,

which was enough to drive him to lie about the car being stolen.

As an ex-police officer, I've dealt with a number of serious collisions.

In my opinion, it's a ridiculous speed

to drive through a 30mph hour speed limit

regardless of whatever time of day or night it is.

He was fortunate, in a way, that it happened

at 4:30 in the morning without any pedestrians.

Goodness knows what would have happened if it had been 4:30 in the afternoon.

Although no-one had been hurt,

the car itself had reached the end of the road.

Our vehicle, the Audi TT,

which is worth about £35,000 was written off,

totally written off by the insurance company.

Mr Kenton had told a very expensive lie

and Neil's team went to pay him a visit.

He was keen for us to actually ask the client face-to-face exactly what had happened.

He said in his statement to us

he'd last seen the car at ten o'clock the previous night,

didn't know anything about the accident,

didn't know anything about the theft,

so we got the recorded phone call and we got the written statement of truth from Mr Kenton.

All of that, alongside the telematics data,

showed that he wasn't telling the truth

and actually proves beyond doubt that he's lied when he said the car was stolen.

The evidence was passed to the police and the case went to court.

He pleaded guilty to dangerous driving,

perverting the course of justice where he was sentenced

to 14 months' imprisonment,

which just goes to show the seriousness

the court system takes this sort of offence.

Later, a personal injury claim for faulty furniture is toppled by CCTV.

It's quite clear from the footage that it didn't happen.

It's quite clear from the footage that she broke our chair.

And it was quite clear from the footage

that it wasn't a genuine accident and no injuries were sustained.

And the claimant goes on the defensive

when their motor insurance scam is stopped in its tracks.

A big growth area in the fight against fraud

is in specialist consultants like Tara Shelton of I-COG.

She uses techniques that identify fraud more swiftly than normal,

all thanks to her remarkable background as a police officer

with a psychology degree.

She can spot a fraudster with just a phone call.

We use nearly 30 indicators

to assist us in assessing that claim.

I'm obviously not going to tell you what they are

because I don't want to divulge that.

One obvious trend that is presented to us

case by case is where customers answer a question with a question

to buy themselves thinking time of how to respond.

This comes under the umbrella of what Tara terms evasive behaviour.

They will intentionally try and divert the call handler

away from the discussion at that present time.

It may be because they feel uncomfortable and because they haven't prepared enough.

As far as Tara's concerned,

there is not one type of person who commits insurance fraud.

I think the people that make claims

actually range in how they present themselves.

So 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 that you should simply provide a police crime number

and an invoice and that's all that's required.

These are the ones that totally underestimate Tara

and her associates in the industry.

These days, all the information that's provided is analysed

and cross-checked so fraudsters with skeletons in their closets

find their past can come back to haunt them.

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

a company that provides specialist insurance for jewellery.

They were contacted by a man who'd taken out a policy with the company.

The claim was originally notified as relating to a ring

and a chunky gold bracelet,

which were stolen by means of assault by two raiders,

with the combined value coming at just under £10,000.

Being mugged isn't something you'd normally laugh about

and that wasn't the only bizarre thing

about the claimant's behaviour.

What we found slightly unusual about the circumstance of this claim

was that the assault took place outside the claimant's home.

Rather than go back into his house, he got in his car,

drove to an unknown destination

and sat in his car for half an hour before contacting the police.

The claimant's version of events simply didn't ring true.

Because the value of this claim was nearly £10,000

and the fact it wasn't immediately reported to the police straight after the incident,

we found this to be slightly suspicious.

If I had been assaulted outside my house, I don't know about you,

but the first thing I would have done is gone back inside my home

and phoned the police from there

so they could attend the scene of the crime

and carry out a search in the local area

for the perpetrators of that particular attack.

TH March decided that before the claim could be progressed,

they needed more information.

What made this particular case difficult

was that upon further questioning,

the claimant became quite evasive and tried to derail the conversation

and take it away from the facts trying to be established.

The claimant tries to steer the conversation

away from the details of what happened

and towards the claims procedure.

Concerned, TH March looked into his past insurance history.

What we found slightly strange is that 12 months beforehand,

this particular claimant had also been assaulted at his home again by two attackers.

Now, the chances of being assaulted once are quite remote.

The chances of being assaulted twice within a 12-month period is extremely remote.

So his home was either some sort of mugging hotspot

or there was something decidedly dubious about the claim.

Either way, TH March's investigations uncovered new evidence

which meant the whole claim was indefinitely detained.

We found out that he had a string of previous convictions

which he did not disclose at the time of taking the policy,

which made the policy worthless.

When the claimant found out they'd rumbled his criminal past,

he still tried to persist,

assuming that a bit of smooth talking would sort everything out.

Nope! As was clearly stated in the wording of the policy.

Realising that not mentioning his past convictions

means the chance of a pay-out is starting to look like ancient history,

the man then attempts to plead his case.

Well, he might not have thought it was a problem,

but it wasn't up to him.

We feel that, due to the circumstances of this particular claim,

it was highly likely that it was a fraudulent claim.

Unsurprisingly, this jewellery claim had lost its sparkle.

It was rejected and the premium returned.

My advice to anybody taking out a policy of insurance is be completely truthful.

Honesty is always the best policy.

For some, a quiet pint in the local

can be a great way to kick-start the weekend after a busy week.

What you don't expect is to be seriously injured.

This CCTV shows a pub manager from UK-wide chain JD Wetherspoon

hurrying to attend to an incident in the beer garden.

A woman who claims to have been injured

is seen next to a broken chair.

She then hobbles back into the pub, assisted by a pal.

Katie Doyle is part of JD Wetherspoon's in-house legal team.

They were contacted by the injured woman's representatives

with an account of what had happened.

We received a letter from the claimant's solicitors

outlining that the claimant had had a fall in the beer garden.

The claimant said that she was sitting on the chair,

the chair collapsed and when the chair collapsed,

she also sustained personal injury.

The woman was claiming that the accident had happened

as a result of a defective chair and therefore the pub was at fault.

On the face of it, her account matched

what the pub manager had observed

when he first arrived on the scene of the accident.

But what the claimant didn't count on

was another witness in the form of the pub garden CCTV camera.

The pub manager revealed that he had the CCTV footage

and it wasn't as the claimant was saying it was.

In fact, rewinding the footage reveals a very different story.

Six and a half minutes before the pub manager was called out to help the injured woman,

this was what had happened.

The claimant was sitting at one end of the beer garden,

but it was in the shade.

She then decided to move with the rest of her party

to the other side of the beer garden.

They then realised that the arm of the chair was a little bit wobbly.

She started wobbling the arm of the chair.

Something tells me she wasn't a qualified carpenter

interested in the chair's construction.

They then broke the arm of the chair.

What they then realised is that this could be a potential claim

so they picked up the chair,

moved it and positioned it on its side on the floor,

at which point the claimant positioned herself

as if the chair had collapsed from beneath her.

The pub manager is then called and comes out to offer assistance.

So it was clear from the CCTV footage

that the incident didn't occur as the claimant was saying it did.

She broke the chair and caused the chair to then be a hazard.

So alarm bells started to ring at head office.

The legal department obviously realised it wasn't a genuine claim.

The legal team informed the claimant's solicitors

that due to the CCTV evidence, they weren't going to admit liability.

At this point, they expected the claimant to take a seat.

The response we received back

was that they were proceeding with the claim,

we were at fault and that we had a responsibility to the customer

to provide a chair that was safe.

They were going to continue to the end with the claim

and they would fight it to the courts if they needed to. We were shocked!

How you could even suggest that was a genuine claim

was beyond Wetherspoons.

It's quite clear from the footage that it didn't happen.

It's quite clear from the footage that she broke our chair

and it was quite clear from the footage

that it wasn't a genuine accident and no injuries were sustained.

The legal team then sent the solicitors

a copy of the footage to prove the woman's claim hadn't got legs.

I think it was at that point that she realised she had been found out.

Wetherspoons had well and truly got the measure of the claimant

and they never heard from her again.

They are opportunists and that's all they are.

They're looking for a quick buck and because we are a big company,

they presume that we've got money

and they can pursue a successful claim against us,

which is actually quite frustrating.

The Wetherspoons One didn't even bother to fake a fall.

But across the pond, the fraudsters are a bit more method,

throwing themselves into the role to put on a convincing performance.

What could be more American

than a family outing that combines shopping and fast food?

Seen here entering his local supermarket,

Tommy Masterson goes straight to the snack section

to stock up on a hot dog.

Minutes later, an apparently unrelated incident occurs

when, in another part of the supermarket,

Lesa Bonilla suffers a horrific accident.

The dramatic fall leaves her floored and helpless.

Other shoppers rush to the women's apparel section to help

and the Phoenix Fire Department is on the scene within minutes,

ensuring that the stricken shopper is given the first aid she so desperately requires.

Bonilla later contacted the supermarket

to claim compensation for her injuries,

which she alleged had been caused by slipping on an unattended hot dog.

She claimed the company had been negligent by not making

the floor safe for shoppers.

The supermarket decided to check out her story

and investigators studied the store's CCTV.

It was only then that they realised that Masterson's hot dog purchase

and Bonilla's fall were in fact related.

The fall certainly looks dramatic, but seconds before,

Masterson appears, hot dog in hand, apparently scanning the area.

He quickly places his hot dog on the floor,

motions to his small companion to keep quiet and then scarpers.

Exactly ten seconds later,

Lesa Bonilla appears with her basket

and in the exact place where Masterson left the hot dog,

she executes her fall.

Let's see that again.

Hot dog down!

Slip up!

Fake accident ahoy!

They were in it together, but their plan had hit a snag.

The CCTV footage showed they'd been telling porkies about Bonilla's accident.

Far from suffering a freak injury involving an errant sausage,

Masterson had deliberately placed it on the floor

for his accomplice to slip on.

The supermarket wasn't prepared to swallow the slippery hot dog story.

They threw out the claim and passed their evidence to the authorities.

It subsequently emerged that the dubious duo

had used the slip-and-fall scam in two other locations,

each time claiming that a hazardous hot dog had been the main culprit.

If Masterson and Bonilla thought their scam would bring home the bacon, they were wrong.

At court, they both pleaded guilty to insurance fraud.

Masterson received three years' probation and a fine

and Bonilla was sentenced to a year in the slammer.

SIREN WAILS

20 years ago, car thefts stood at over 600,000 per year.

But, thanks to advances in vehicle security,

thefts have dropped to a fraction of that total.

Even so, it's still a major concern for drivers.

One policy holder who experienced this first-hand was Miss Carr.

LV's Clare Lunn worked on the case.

The claim was reported to the LV claims department

and it involved the theft of a BMW,

which was worth in the region of £10,000.

During the phone call, Miss Carr seemed vague about the details

and the insurers became concerned.

The sequence of events that she gave

with regards to the theft of the vehicle were inconsistent

and therefore we felt that we needed to investigate it further.

During a subsequent call,

the claims handler requested the vehicle documents and the keys,

the claimant having confirmed that she still had both sets.

"Bang out of order" is a description

that could also be applied to the keys that she eventually sent in.

When we received the two sets of keys, they were obviously different.

They were a different shape, a different size, a different weight

and when we investigated one set of the keys in more detail,

it literally sort of broke in our hands.

At this point, you immediately start to doubt

what the insured has told us

about the circumstances relating to the theft

and you start wondering what's happened to the original keys

and were they used to steal the vehicle.

The keys were sent off for testing

and the claims handler called again

to try and unlock the inconsistencies in the case.

Even Miss Carr seemed unsure which key was which

and she started to go on the defensive.

The key manufacturers then came back to LV with the results of the tests.

They advised that the key that had fallen apart was a false key

and the other key wasn't actually registered to the claimant's vehicle

and hadn't actually been used since 2010

so we now knew that the claimant

had actually told us an untruth.

With evidence that Miss Carr had lied,

Clare felt she had more than enough grounds to shut the door on the case.

At that point, we repudiated the claim

and we passed our concerns on to the police.

They launched an investigation

and finally the true story of the missing car was revealed.

The police discovered that our claimant had in fact

arranged with a male associate

for them to take her vehicle and sell the vehicle for parts.

The theft of the vehicle never occurred

and it was a staged theft all along.

The male associate stood to gain financially

from the sale of the vehicle and the parts

and our claimant put in a fraudulent claim

so that they were going to gain financially

from an insurance claim in the region of £10,000.

It was a brazen attempt to defraud the insurers and dispose of the vehicle,

but Miss Carr wasn't prepared to walk away with nothing once her claim was rejected.

She then called the male

and demanded 50% of the money that he'd made from the vehicle.

When he refused to give her any money,

then she threatened the male,

saying that she'd actually contact the police

and say that he'd stolen her vehicle.

Fortunately for the man,

he had thought to record the call recordings

between him and our claimant

and he passed those over to the police for their investigation.

With the evidence closing in, the case proceeded to court.

Our claimant, Miss Carr, was prosecuted and found guilty of fraud.

She received a fine of £620

and was ordered to complete 200 hours of community service.

This sends out a strong message to any have-a-go fraudster

that insurance is not an easy target

and that we will push for the most severe sentence.