Episode 9

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0:00:02 > 0:00:05Insurance fraud in the UK has hit epidemic levels.

0:00:05 > 0:00:08It's costing us over £1.3 billion every year.

0:00:08 > 0:00:11That's almost £3.6 million every day.

0:00:13 > 0:00:18Deliberate crashes, bogus personal injuries, even phantom pets.

0:00:19 > 0:00:22The fraudsters are risking more and more to make a quick killing,

0:00:22 > 0:00:26and every year it's adding over £50 to your insurance bill.

0:00:27 > 0:00:32But insurers are fighting back, exposing 14 fake claims every hour.

0:00:32 > 0:00:35Armed with covert surveillance systems...

0:00:35 > 0:00:38Subject out of vehicle...

0:00:38 > 0:00:42..sophisticated data analysis techniques...

0:00:42 > 0:00:43Police!

0:00:43 > 0:00:45..and a number of highly skilled police units...

0:00:45 > 0:00:47Police, stand back, stay where you are!

0:00:47 > 0:00:49..they're catching the criminals red-handed.

0:00:49 > 0:00:51Just don't lie to us.

0:00:51 > 0:00:54All those con men, scammers and cheats on the fiddle,

0:00:54 > 0:00:58are now caught in the act and claimed and shamed.

0:01:05 > 0:01:11Coming up: A fraudster bends the truth about his bad back.

0:01:11 > 0:01:15However, when Paul Gustar left the building, the doctor saw him

0:01:15 > 0:01:18walk away, not using the stick.

0:01:18 > 0:01:20In Las Vegas, the chips are down

0:01:20 > 0:01:22for a pair of criminals caught in the act.

0:01:24 > 0:01:26And it's not all roses for a potential

0:01:26 > 0:01:28fraudster on Valentine's night.

0:01:28 > 0:01:30They knew they were going to make a claim,

0:01:30 > 0:01:33and they needed the photographs to help support that claim.

0:01:39 > 0:01:41The workplace is a hive of activity.

0:01:41 > 0:01:45Whether it's a building site, an office or even a haulage firm,

0:01:45 > 0:01:48transporting goods from A to B.

0:01:48 > 0:01:51Thankfully, with health and safety being such a priority nowadays,

0:01:51 > 0:01:54the number of work-related injuries has been levelling off

0:01:54 > 0:01:58in recent years, but even so, there's bound to be the odd mishap.

0:01:59 > 0:02:01So when accidents do happen,

0:02:01 > 0:02:04an insurance policy could be worth its weight in gold.

0:02:06 > 0:02:09Meet Paul Gustar. He may be sat in his car here,

0:02:09 > 0:02:12but he used to be employed by a haulage lorry firm.

0:02:12 > 0:02:14Unfortunately, Gustar was one of the unlucky ones

0:02:14 > 0:02:17who suffered an accident at work,

0:02:17 > 0:02:20but never fear, insurance company Axa was there to help him

0:02:20 > 0:02:23in his time of need, as Richard Davies explains.

0:02:24 > 0:02:28When the claim first came into Axa at the back end of 2007,

0:02:28 > 0:02:32Paul Gustar told us he had a very serious back injury,

0:02:32 > 0:02:35he told us he couldn't work, he told us he couldn't walk very well,

0:02:35 > 0:02:38and in fact, he told us that his whole life was

0:02:38 > 0:02:42being destroyed by the back pain and was claiming around £100,000

0:02:42 > 0:02:46because he couldn't work as a result of that condition.

0:02:46 > 0:02:49Anyone who's suffered from back pain will tell you what a

0:02:49 > 0:02:51crippling condition it can be, but Gustar was claiming

0:02:51 > 0:02:54that it was his work that had caused the problem.

0:02:54 > 0:02:58Paul Gustar was a packer, he worked inside a warehouse,

0:02:58 > 0:03:01he'd said that he'd twisted his back whilst he was working.

0:03:01 > 0:03:04He normally would carry out an action which required him

0:03:04 > 0:03:09to move from left to right between 100 and 200 times an hour.

0:03:09 > 0:03:13But what really alerted Axa to foul play is that during

0:03:13 > 0:03:15the early stages of the investigation,

0:03:15 > 0:03:17Gustar moved the goalposts.

0:03:17 > 0:03:20Soon after the claim was submitted was a change in story.

0:03:20 > 0:03:24Instead of the injury being caused by a twisting of the back,

0:03:24 > 0:03:28he was now saying that he'd slipped on a wet surface inside a lorry

0:03:28 > 0:03:31and claiming that that was caused his back injury.

0:03:31 > 0:03:35And for us, such a significant change in story was a real red flag.

0:03:35 > 0:03:38With a colossal claim on the cards, Axa wanted to carry out

0:03:38 > 0:03:41a few checks before they settled it.

0:03:41 > 0:03:43And in cases like this,

0:03:43 > 0:03:45undercover surveillance is an insurer's best friend,

0:03:45 > 0:03:49because as we all know, the camera never lies.

0:03:49 > 0:03:51Time of day is stated,

0:03:51 > 0:03:55observations in respect of Paul Gustar.

0:03:55 > 0:03:57Yep, you guessed it,

0:03:57 > 0:04:01it was at this point in the road that Gustar's claim hit the skids.

0:04:01 > 0:04:07We wanted to verify that he actually was in such pain that he couldn't work.

0:04:07 > 0:04:11So the surveillance team kept a watchful eye on Gustar's every move.

0:04:11 > 0:04:14Paul Gustar told us that his injury meant that he couldn't

0:04:14 > 0:04:17walk easily, that he was in a lot of pain,

0:04:17 > 0:04:20and that he would need a stick to get around at all times.

0:04:20 > 0:04:24Our surveillance showed something very different.

0:04:24 > 0:04:25Too right it did.

0:04:25 > 0:04:28And quite frankly, Axa couldn't believe their eyes.

0:04:28 > 0:04:31We can see him walking normally...

0:04:31 > 0:04:34Hardly looks like a man who's struggling to get about.

0:04:34 > 0:04:37..we can see him going into shops...

0:04:37 > 0:04:41He's come out of the coffee shop, subject's standing on foot and into Maplin Electronics.

0:04:42 > 0:04:46Ah, a nice bit of retail therapy. Just what the doctor ordered!

0:04:46 > 0:04:48..we can see him bending down...

0:04:48 > 0:04:51Ah, there's the crippling back condition!

0:04:51 > 0:04:53Has it locked up?

0:04:53 > 0:04:55No, false alarm.

0:04:56 > 0:04:59..we can see him going to a pub.

0:04:59 > 0:05:01Hold on, rewind.

0:05:01 > 0:05:04You're off sick and you're shopping and you're having a swift half?

0:05:04 > 0:05:07Mind it doesn't interfere with your medication.

0:05:07 > 0:05:11That appeared to be somebody who has a relatively normal life,

0:05:11 > 0:05:13certainly not somebody who's completely incapacitated

0:05:13 > 0:05:16by a back injury which was stopping him working,

0:05:16 > 0:05:20and indeed walking in a normal way.

0:05:20 > 0:05:24With alarm bells ringing louder, Axa explored other avenues.

0:05:24 > 0:05:26And a quick chat to Gustar's employer

0:05:26 > 0:05:30brought about an interesting piece of evidence.

0:05:30 > 0:05:34He told us that he'd received a text message from Mr Gustar's partner,

0:05:34 > 0:05:37and she said that she thought that the back injury

0:05:37 > 0:05:41might have been caused by Paul Gustar pushing the car up a hill.

0:05:41 > 0:05:44Well, that's thrown a spanner in the works.

0:05:44 > 0:05:47Pushing a car? Up a hill?!

0:05:47 > 0:05:50No wonder you've got bother with your back, mate.

0:05:50 > 0:05:54We were able to show that The AA had been called out

0:05:54 > 0:05:55to the car at the same time.

0:05:55 > 0:05:59So we were convinced that the vehicle had indeed broken down.

0:05:59 > 0:06:02For us, that added some credibility to the thought

0:06:02 > 0:06:06that Paul Gustar had injured his back whilst pushing a vehicle up a hill.

0:06:06 > 0:06:08He might have been wearing camouflage

0:06:08 > 0:06:11in the surveillance footage, but there was no hiding the fact

0:06:11 > 0:06:16that Gustar was attempting to con Axa out of £100,000.

0:06:16 > 0:06:20It does appear that in this case the employee is making up that claim,

0:06:20 > 0:06:23that actually the injury, if it existed,

0:06:23 > 0:06:25was nothing like as bad as he said it was

0:06:25 > 0:06:27and indeed, as we found out,

0:06:27 > 0:06:31that Paul Gustar may have had a back injury

0:06:31 > 0:06:33before he submitted the claim to us.

0:06:33 > 0:06:35When it comes to personal injury claims,

0:06:35 > 0:06:39medical evidence is a must, but unfortunately for Gustar,

0:06:39 > 0:06:43a trip to the doctor proved to be the kiss of death for his claim.

0:06:43 > 0:06:46The key piece of evidence came from his doctor.

0:06:46 > 0:06:49It's doctors that normally provide the confirmation

0:06:49 > 0:06:52that an injury has actually occurred.

0:06:52 > 0:06:57And one particular doctor assessed Paul Gustar's injury.

0:06:57 > 0:07:02He told us that when Paul Gustar entered his office,

0:07:02 > 0:07:04he appeared to be in a lot of pain,

0:07:04 > 0:07:08that he was walking with a stick and was walking with some difficulty.

0:07:08 > 0:07:11However, when Paul Gustar left the building,

0:07:11 > 0:07:13the doctor saw him walk away,

0:07:13 > 0:07:18not using the stick, and walk away without any visible pain.

0:07:18 > 0:07:20Between the surveillance, the incriminating text

0:07:20 > 0:07:24and the statement from the doctor, Axa had a mountain of evidence

0:07:24 > 0:07:26and unsurprisingly denied the claim.

0:07:26 > 0:07:28When the evidence was put to Paul Gustar,

0:07:28 > 0:07:30he decided to walk away.

0:07:30 > 0:07:34He decided that he didn't want to make that claim any more.

0:07:34 > 0:07:36With an apparently non-existent back injury,

0:07:36 > 0:07:39walking away wasn't a problem for Gustar.

0:07:39 > 0:07:40But what he didn't bank on, though,

0:07:40 > 0:07:44was that Axa had no intention of letting this go.

0:07:44 > 0:07:48If a fraudster is allowed to walk away from a claim,

0:07:48 > 0:07:53they have no consequence in actually making that fraudulent claim.

0:07:53 > 0:07:54That's wrong.

0:07:54 > 0:07:57And we don't think that fraudsters should be allowed to walk away

0:07:57 > 0:07:59from that as a situation.

0:08:00 > 0:08:04AXA took Gustar to court, where he was found guilty of fraud

0:08:04 > 0:08:07and sentenced to a three-year suspended sentence.

0:08:07 > 0:08:11In his attempt to swindle £100,000 out of his employer,

0:08:11 > 0:08:13Gustar really had fallen flat on his back

0:08:13 > 0:08:17and was incredibly fortunate not to have wound up behind bars.

0:08:17 > 0:08:22We think it's important that the fraudsters should actually face some kind of sentence.

0:08:22 > 0:08:25Whether or not that prison sentence is suspended, we don't mind,

0:08:25 > 0:08:28but we do feel that they should end up with a criminal record.

0:08:28 > 0:08:31And that's exactly what he got.

0:08:31 > 0:08:33Bet that's the last time he'll complain of a bad back!

0:08:38 > 0:08:41Still to come - a potential fraudster

0:08:41 > 0:08:45submits a claim for a poorly puppy, but will the insurer bite?

0:08:45 > 0:08:49We listened to the policy holder, we listened to the breeder calls.

0:08:49 > 0:08:51The breeder call was exactly the same voice.

0:08:51 > 0:08:56And a bogus burglar who was just too organised for his own good.

0:08:56 > 0:08:59The first thing they noticed was a folder entitled List Of Items Taken,

0:08:59 > 0:09:03which straight away, they thought, "This seems very strange."

0:09:11 > 0:09:14It's estimated around 8.5 million dogs

0:09:14 > 0:09:16make up the UK's pet population.

0:09:17 > 0:09:22But with the average vet bill for a dog costing around £300 a year,

0:09:22 > 0:09:24keeping a pet can be rather costly.

0:09:24 > 0:09:27So when your little pooch falls ill and needs expensive treatment,

0:09:27 > 0:09:29pet insurance is a must.

0:09:29 > 0:09:32However, some unscrupulous pet owners will weave a tangled web

0:09:32 > 0:09:34to get an insurer to cough up,

0:09:34 > 0:09:40as Simon Wheeler from Agria found out when it came to a claim involving a wounded puppy.

0:09:40 > 0:09:43We received a claim from the owner of a pug puppy,

0:09:43 > 0:09:46who sadly had injured its eye,

0:09:46 > 0:09:50and taken the puppy to the vet to have the eye treated.

0:09:50 > 0:09:53Sadly, the puppy had died under general anaesthetic.

0:09:53 > 0:09:58The owner put in a claim of £432 to cover the vet fees.

0:09:58 > 0:10:01But they were rather vague when it came to the details.

0:10:01 > 0:10:04They weren't sure whether the puppy was insured or not

0:10:04 > 0:10:07so they were asking us what the policy number was,

0:10:07 > 0:10:10they didn't seem to have a policy number,

0:10:10 > 0:10:13they were asking us why they hadn't got any policy documentation

0:10:13 > 0:10:16so some strange questions for somebody who believed

0:10:16 > 0:10:18they had an insurance policy.

0:10:18 > 0:10:22To be fair to the claimant, breeders sometimes set up policies themselves

0:10:22 > 0:10:25so the claimant got in touch with the breeder to help clear things up.

0:10:26 > 0:10:28The breeder and policy holder obviously spoke

0:10:28 > 0:10:31and the policy holder called us again

0:10:31 > 0:10:34and said that the breeder had set up the policy

0:10:34 > 0:10:38three or four days before the incident occurred.

0:10:38 > 0:10:43They thought they provided a receipt and they thought they provided policy documentation,

0:10:43 > 0:10:45but again the whole process was very, very vague.

0:10:45 > 0:10:49Agria made some routine inquiries and contacted the vet.

0:10:49 > 0:10:52The good news was that they found a policy.

0:10:52 > 0:10:55The bad news is that it wasn't worth the paper it was written on.

0:10:55 > 0:10:57Gawping mistake!

0:10:57 > 0:11:01The policy had been set up on the day that the operation had occurred,

0:11:01 > 0:11:06therefore the condition was pre-existing to the insurance being set up.

0:11:06 > 0:11:08There might have been a policy, but for Agria,

0:11:08 > 0:11:10it didn't make a difference.

0:11:10 > 0:11:12Because the puppy had a pre-existing condition,

0:11:12 > 0:11:14the policy was null and void.

0:11:14 > 0:11:16At the point that we declined the claim,

0:11:16 > 0:11:18the policy holder became quite upset, pleaded with us

0:11:18 > 0:11:24to cover the condition and again we refused.

0:11:24 > 0:11:27Agria weren't going to roll over and it's just as well

0:11:27 > 0:11:31because this claim hadn't been put to bed just yet.

0:11:31 > 0:11:34Bizarrely, about 20-30 minutes later,

0:11:34 > 0:11:37we got a call from the breeder.

0:11:37 > 0:11:41The breeder activating cover at that point, giving us a false date of sale

0:11:41 > 0:11:46so endeavouring to backdate the cover to cover the condition.

0:11:46 > 0:11:48Agria smelled a rat.

0:11:48 > 0:11:51The timing of the phone call from the breeder

0:11:51 > 0:11:56was too much of a coincidence so they went back and listened to the phone calls again.

0:11:56 > 0:11:58When we started to investigate both calls,

0:11:58 > 0:12:02we listened to the policy holder, we listened to the breeder calls.

0:12:02 > 0:12:05It had been very noticeable that the policy holder

0:12:05 > 0:12:10had quite a distinctive accent and quite a pronounced stammer.

0:12:10 > 0:12:14The breeder call was exactly the same voice - same accent

0:12:14 > 0:12:17and same stammer.

0:12:17 > 0:12:20The phone call appeared to have been a last-ditch attempt

0:12:20 > 0:12:22to set up a policy that would pay out.

0:12:22 > 0:12:25Not swayed, Agria still declined the claim.

0:12:25 > 0:12:26But to their surprise,

0:12:26 > 0:12:29the policy holder wouldn't let sleeping dogs lie.

0:12:29 > 0:12:31Even after the claim was rejected,

0:12:31 > 0:12:34they still pushed to have the claim settled

0:12:34 > 0:12:38and referred it to the FOS, the Financial Ombudsman Service.

0:12:38 > 0:12:40It's the first point of referral

0:12:40 > 0:12:44when the policy holders have claims they're not happy with the assessment of.

0:12:44 > 0:12:47Agria continued to dig away with their own investigation.

0:12:47 > 0:12:50After analysing earlier phone calls,

0:12:50 > 0:12:53they suspected the policy holder had been impersonating the breeder,

0:12:53 > 0:12:57but it turned out there was a lot more to their relationship than they'd realised.

0:12:57 > 0:13:02When we started to look at some of the documentation that had come in,

0:13:02 > 0:13:04so very obviously the postcode for the breeder

0:13:04 > 0:13:09was the same as the postcode given by the policy holder when we spoke to them.

0:13:09 > 0:13:11When the breeder telephoned us,

0:13:11 > 0:13:16it was on the same number that the policy holder had given us.

0:13:16 > 0:13:18With a bit more investigation,

0:13:18 > 0:13:21it became clear why this pair had so much in common.

0:13:21 > 0:13:24The breeder and the owner were co-habiting

0:13:24 > 0:13:28and actually the breeder was expecting the owner's baby at that time.

0:13:28 > 0:13:30With this evidence in hand,

0:13:30 > 0:13:33Agria invited the couple in to talk about their findings,

0:13:33 > 0:13:36but their actions spoke louder than words.

0:13:36 > 0:13:39The meeting was set up, the date arranged, the place arranged.

0:13:39 > 0:13:41The policy holder never turned up.

0:13:41 > 0:13:43It's no wonder they didn't turn up

0:13:43 > 0:13:48and the findings of the Financial Ombudsman Service didn't come as much of a surprise either.

0:13:48 > 0:13:54The incident was pre-existing to the insurance if the insurance had been set up properly

0:13:54 > 0:13:57so the FOS found obviously in favour of Agria.

0:14:00 > 0:14:04Putting a claim in to try and recoup some vet fees is one thing,

0:14:04 > 0:14:07but our next claimant took things to a whole new level.

0:14:07 > 0:14:10Halfway across the world in Las Vegas,

0:14:10 > 0:14:16a pet business hit the headlines after the owner tried to swindle insurers out of 100,000.

0:14:19 > 0:14:23It's almost 1am at Prince & Princess Pet Shop.

0:14:23 > 0:14:26The CCTV'S on, capturing the night's events.

0:14:29 > 0:14:31The front door has just opened.

0:14:31 > 0:14:35Is this an unexpected prowler hoping to make a few bucks?

0:14:36 > 0:14:40No, thankfully it's the owner, Gloria Eun Hye Lee.

0:14:40 > 0:14:44It's a little early to be opening for business though, wouldn't you say?

0:14:45 > 0:14:48This CCTV footage proved to be vital

0:14:48 > 0:14:51because Lee wasn't here to do some late night paperwork.

0:14:51 > 0:14:54In fact, she was about to commit a diabolical crime,

0:14:54 > 0:14:57but she made a whopping mistake.

0:14:57 > 0:14:59Disappearing into the office,

0:14:59 > 0:15:02she went to disconnect the feed to the CCTV.

0:15:02 > 0:15:05But this flick of the switch was about to land her in hot water

0:15:05 > 0:15:08because she removed the utility cord instead,

0:15:08 > 0:15:14which left the world and his wife to see her crime revealed before their very eyes.

0:15:14 > 0:15:15Bet she was kicking herself for that

0:15:15 > 0:15:18when she later appeared in front of the judge.

0:15:18 > 0:15:22But our criminal wasn't on her lonesome in what was about to unfold.

0:15:22 > 0:15:25Lee had a partner in crime in the shape of Mr Kirk Bills,

0:15:25 > 0:15:27who was her partner in more ways than one

0:15:27 > 0:15:30because she was seeing him behind her husband's back.

0:15:31 > 0:15:33But he didn't turn up empty handed.

0:15:33 > 0:15:36He's carrying two cans filled to the brim with kerosene

0:15:36 > 0:15:39and he doesn't waste any time in dowsing the place with fuel.

0:15:42 > 0:15:44With two dogs and 25 puppies in the shop,

0:15:44 > 0:15:46Bills was heartless in his act

0:15:46 > 0:15:49and can clearly be seen randomly throwing kerosene,

0:15:49 > 0:15:52including, unbelievably, onto the animals' cages.

0:15:58 > 0:16:01With the scene set, Lee disappears from the pet shop,

0:16:01 > 0:16:03leaving Bills to light the touch paper.

0:16:12 > 0:16:15Within seconds, the fire takes hold.

0:16:30 > 0:16:32Bills makes a hasty exit,

0:16:32 > 0:16:35leaving the animals to perish as the store goes up in flames.

0:16:39 > 0:16:41Thankfully, the store sprinkler system kicked in,

0:16:41 > 0:16:44saving all 27 pets from the flames.

0:16:47 > 0:16:50In October 2014, Lee and Bills pleaded guilty to arson

0:16:50 > 0:16:52and cruelty to animals.

0:16:52 > 0:16:55Lee also pleaded guilty to insurance fraud,

0:16:55 > 0:16:57but then played what she thought was her trump card

0:16:57 > 0:16:59by announcing she was pregnant.

0:16:59 > 0:17:01However, the judge wasn't swayed,

0:17:01 > 0:17:04saying the Nevada jail system was well equipped for this.

0:17:04 > 0:17:07Lee was sentenced to a maximum of 14 years in prison

0:17:07 > 0:17:12with her being eligible for parole after she spends five years behind bars.

0:17:12 > 0:17:14Bills was given 4-10 years in jail

0:17:14 > 0:17:17for his part in the despicable crime.

0:17:17 > 0:17:20On sentencing, the judge commented on their appalling act, saying...

0:17:30 > 0:17:32For this merciless act,

0:17:32 > 0:17:35these criminals got what they well and truly deserved.

0:17:43 > 0:17:46Red roses, chocolates, Cupids and hearts -

0:17:46 > 0:17:49all romantic gestures for the one you love.

0:17:49 > 0:17:52We all know that the way to man's heart is through his stomach,

0:17:52 > 0:17:54but on February 14th,

0:17:54 > 0:17:57you can't get a table at a fancy restaurant for love or money.

0:17:57 > 0:18:01John Beadle from RSA came across a claim from a damsel

0:18:01 > 0:18:03who'd found more than her Prince Charming.

0:18:03 > 0:18:07This has got a bit of a romantic twist to it, this story,

0:18:07 > 0:18:12because it allegedly happened on Valentine's night

0:18:12 > 0:18:15and a lady and her partner had booked a table

0:18:15 > 0:18:20and were on their way to have a romantic Valentine's dinner.

0:18:20 > 0:18:24This loving couple are all set for a romantic night out.

0:18:25 > 0:18:30But will Cupid's arrow be on target? Aww, isn't love grand?

0:18:31 > 0:18:34Is she about to be swept off her feet?

0:18:34 > 0:18:39They claimed that the lady tripped over in a pothole in the car park.

0:18:40 > 0:18:43And injured herself.

0:18:43 > 0:18:45SHE SCREAMS

0:18:45 > 0:18:49And she alleged that this was the liability of the pub.

0:18:50 > 0:18:54For our two lovebirds, this was a disastrous night

0:18:54 > 0:18:55that was well and truly spoiled.

0:18:55 > 0:18:58The insurer tried to get to the heart of the matter,

0:18:58 > 0:19:00but, after speaking to the pub owner,

0:19:00 > 0:19:03it seemed that this claim might be on the rocks.

0:19:03 > 0:19:07At the time that the accident allegedly happened,

0:19:07 > 0:19:10the pub had actually stopped serving food.

0:19:10 > 0:19:13They were, as you would be on Valentine's night,

0:19:13 > 0:19:16completely full and I know, from personal experience,

0:19:16 > 0:19:20it's very difficult to get a seat in a restaurant.

0:19:20 > 0:19:22They had no reservation.

0:19:22 > 0:19:25Arriving without a booking after the pub had stopped serving,

0:19:25 > 0:19:27they were definitely pushing it to get a bite to eat.

0:19:27 > 0:19:29Were they on their way for a loved-up dinner

0:19:29 > 0:19:31or just looking for someone else to foot the bill?

0:19:31 > 0:19:34In a case like this, you really need an eye witness.

0:19:34 > 0:19:38Fortunately, the CCTV cameras next to the pub had all angles covered

0:19:38 > 0:19:41and one camera gave a bird's eye view.

0:19:41 > 0:19:44We reviewed the CCTV footage from the pub

0:19:44 > 0:19:47and one of the cameras covered the car park

0:19:47 > 0:19:50and we observed that the claimant

0:19:50 > 0:19:55and her partner came into the car park, parked the car and,

0:19:55 > 0:19:59rather than heading into the pub, went to the pothole.

0:19:59 > 0:20:02That all sounds a bit bizarre, if you ask me.

0:20:02 > 0:20:06Let's find out what really happened in the car park.

0:20:10 > 0:20:15So the couple did drive in. They got out and walked through the car park.

0:20:15 > 0:20:18Hope you clocked that they weren't holding hands!

0:20:18 > 0:20:21Not sure she's fallen head over heels, though.

0:20:21 > 0:20:24It's all a bit suspect, if you want my opinion.

0:20:24 > 0:20:29The lady in question and her partner were taking photographs of the pothole.

0:20:29 > 0:20:31Photographs!

0:20:33 > 0:20:35Yes, that's clearly a camera flash.

0:20:37 > 0:20:42So, let's get this straight - they parked up, jumped out,

0:20:42 > 0:20:45took a few snapshots of the pothole

0:20:45 > 0:20:48and they didn't even go in the pub for dinner.

0:20:49 > 0:20:52We feel this was all a premeditated step.

0:20:52 > 0:20:54They knew they were going to make a claim

0:20:54 > 0:20:57and they needed the photographs to help support that claim.

0:20:57 > 0:20:59The way you're running to your car,

0:20:59 > 0:21:03you don't look like you've much of an injury there, sweetheart.

0:21:03 > 0:21:07These people simply weren't there, didn't have a reservation

0:21:07 > 0:21:09and weren't on their way to dinner at the pub.

0:21:11 > 0:21:14Unsurprisingly, RSA weren't going to pay up,

0:21:14 > 0:21:17which meant that this potential fraudster could kiss her claim goodbye.

0:21:25 > 0:21:27In January 2012,

0:21:27 > 0:21:30the police joined the fight against insurance fraud

0:21:30 > 0:21:35by forming an elite squad known as IFED, the Insurance Fraud Enforcement Department.

0:21:35 > 0:21:37There's different types of insurance fraudsters.

0:21:37 > 0:21:41You have the opportunists, who'll exaggerate a small claim to make a slightly bigger gain,

0:21:41 > 0:21:45and then you have the organised crime element that do this for a living.

0:21:45 > 0:21:47They've made over 660 arrests

0:21:47 > 0:21:50and have saved millions of pounds in fraudulent insurance claims,

0:21:50 > 0:21:54money which ultimately goes back in our pockets.

0:21:54 > 0:21:57From now on, fraudsters need to watch their backs.

0:21:57 > 0:21:59Insurance fraud isn't a victimless crime.

0:21:59 > 0:22:03If commit insurance fraud in England and Wales, we'll find you.

0:22:03 > 0:22:05Police! Don't move, stay where you are!

0:22:06 > 0:22:10One case that landed on IFED's desk was particularly unusual.

0:22:10 > 0:22:12In September 2012,

0:22:12 > 0:22:15Nicholas Warner reported he'd been the victim of a burglary.

0:22:16 > 0:22:20Although even by his own admission, the thief's method of entry

0:22:20 > 0:22:25was rather out of the ordinary, as DC Aman Taylor explains.

0:22:25 > 0:22:28As he reported it, he said the circumstances seemed improbable,

0:22:28 > 0:22:30they didn't seem right,

0:22:30 > 0:22:33saying that he'd left his keys in an open locker within a gym.

0:22:33 > 0:22:36The keys had been taken from his bag

0:22:36 > 0:22:39and someone had somehow located his home address.

0:22:39 > 0:22:42They were then used to open his door, go in, ransack his flat

0:22:42 > 0:22:45and take a load of items of high value.

0:22:45 > 0:22:47As unusual as the circumstances were,

0:22:47 > 0:22:49thankfully Warner was a very organised individual,

0:22:49 > 0:22:52which was rather handy when it came to his claim.

0:22:53 > 0:22:57He supplied proofs of ownership in the form of a lost list

0:22:57 > 0:23:02and on that lost list, he detailed all of the items that were stolen.

0:23:02 > 0:23:05But this list seemed never-ending.

0:23:05 > 0:23:08As he said he found further items had been stolen,

0:23:08 > 0:23:11- he produced further lost lists. - Of course he did!

0:23:11 > 0:23:13And this ever-growing list of stolen gear

0:23:13 > 0:23:16had now grown to something in the region of £30,000.

0:23:16 > 0:23:19Various different items of jewellery - earrings, necklaces,

0:23:19 > 0:23:22bracelets, as well as a number of electrical items.

0:23:22 > 0:23:29There was Wii games, phones and in particular one laptop.

0:23:29 > 0:23:31A variety of household items that you'd expect to find

0:23:31 > 0:23:35in a home belonging to a couple.

0:23:35 > 0:23:39Right from the start, Warner didn't appear to put his best foot forward.

0:23:39 > 0:23:45In that first phone call, he said, "There's a Jimmy Choo handbag here and they haven't taken it."

0:23:45 > 0:23:47Then when he submitted his lost list,

0:23:47 > 0:23:50one of the items on the lost list was "Jimmy Choo handbag".

0:23:50 > 0:23:52Bet the Mrs wasn't a happy bunny!

0:23:52 > 0:23:55But Warner's organisational skills were about to trip him up.

0:23:55 > 0:23:59One e-mail in particular, which was a photograph of a laptop.

0:23:59 > 0:24:01The laptop screen is open.

0:24:01 > 0:24:04The first thing they noted was a folder entitled List Of Items Taken,

0:24:04 > 0:24:10- which straight away they thought, "This seems very strange."- Oh, dear!

0:24:10 > 0:24:15Never mind a slip-up - this was more like what you'd call dropping yourself right in it.

0:24:15 > 0:24:17Then when they looked at the metadata of the photograph,

0:24:17 > 0:24:20which contains when and where it was taken,

0:24:20 > 0:24:26they saw it was taken on the same date that the e-mail was sent so two weeks after the burglary.

0:24:26 > 0:24:30Warner claimed it was all down to a hiccup with the latest technology.

0:24:30 > 0:24:32Yep, that old chestnut!

0:24:32 > 0:24:34But the insurer wasn't falling for that one

0:24:34 > 0:24:36so they rejected the claim and referred it to IFED,

0:24:36 > 0:24:39who paid the suspected fraudster a home visit.

0:24:39 > 0:24:41We found different items of jewellery,

0:24:41 > 0:24:45all of which matched with the same sets that were reported stolen in the burglary.

0:24:45 > 0:24:47But it was when they came across Warner's laptop

0:24:47 > 0:24:49that IFED really hit the jackpot.

0:24:49 > 0:24:52After closer inspection, it was the same make and model

0:24:52 > 0:24:54as the one reported stolen in the burglary.

0:24:55 > 0:24:57On the laptop was the final piece of the jigsaw -

0:24:57 > 0:25:01Warner's list of stolen items.

0:25:01 > 0:25:03I had the laptop examined by a company.

0:25:03 > 0:25:07One thing I particularly asked them to focus on was this List Of Items Taken,

0:25:07 > 0:25:13which was the document folder contained on the homescreen.

0:25:13 > 0:25:15When they looked at the dates of that folder,

0:25:15 > 0:25:18you could see it was created four days prior to the burglary

0:25:18 > 0:25:22and contained within that folder were six items which matched

0:25:22 > 0:25:25with the top six items as per the lost list which was subsequently

0:25:25 > 0:25:28reported to the insurance company.

0:25:28 > 0:25:32So, he created his list of stolen items before the break-in

0:25:32 > 0:25:36and saved it on his laptop. Now, that was a little silly!

0:25:36 > 0:25:38Even with all this concrete evidence,

0:25:38 > 0:25:41Warner still wouldn't budge.

0:25:41 > 0:25:44He made a partial admission, saying it had been exaggerated,

0:25:44 > 0:25:48but he wouldn't out and out say, "This is clearly a staged burglary,"

0:25:48 > 0:25:51or, "This didn't occur and I was trying to make a claim

0:25:51 > 0:25:55"through my own means to gain a financial advantage," he wouldn't say that.

0:25:55 > 0:25:58By the time he was put in front of the judge,

0:25:58 > 0:26:00Warner had come clean and in January 2015,

0:26:00 > 0:26:05pleaded guilty to fraud by false representation at Bristol Crown Court.

0:26:05 > 0:26:08He received a ten-month suspended sentence

0:26:08 > 0:26:09and 270 hours' community service.

0:26:09 > 0:26:13Something which, on the face of it, appears quite simple,

0:26:13 > 0:26:19we can detect it and we will look to take every sort of avenue to find out what has gone on.

0:26:21 > 0:26:25For the unfortunate ones who really are victims of this terrible crime,

0:26:25 > 0:26:29being burgled isn't just about having personal possessions stolen.

0:26:29 > 0:26:31It's an experience which Andrew Tancock

0:26:31 > 0:26:34and Michelle Bressington are all too familiar with,

0:26:34 > 0:26:38after returning home from holiday to find their home had been broken into.

0:26:39 > 0:26:46It is a real horrible violation to your personal space.

0:26:46 > 0:26:50It just made me feel really sick and really frightened

0:26:50 > 0:26:56that they'd come in, taken all our stuff and been in our home.

0:26:58 > 0:27:00It's just the most horrible feeling ever.

0:27:01 > 0:27:04It's not just items like TV and cash that are stolen,

0:27:04 > 0:27:07but it's possessions with great sentimental value.

0:27:07 > 0:27:11Like rings and things which you can't really get back

0:27:11 > 0:27:16because one was a bespoke ring, which was just made purely for me.

0:27:16 > 0:27:19So things like that, you can't really replace.

0:27:20 > 0:27:23But the worst impact of a burglary doesn't go away easily.

0:27:23 > 0:27:27I didn't even want to be in the house because I felt scared

0:27:27 > 0:27:32and weeks after, I kept checking all the doors were locked around the house.

0:27:32 > 0:27:34It became an obsession

0:27:34 > 0:27:38and I didn't want to be in the house at night on my own.

0:27:38 > 0:27:41Understandably, Andrew and Michelle have no sympathy

0:27:41 > 0:27:45for those who attempt to cash in on staged burglaries.

0:27:45 > 0:27:50People who stage fictitious burglaries, yeah,

0:27:50 > 0:27:52it just makes you really angry.

0:27:52 > 0:27:54They're just in it for themselves

0:27:54 > 0:27:59and they don't think about anybody else and then people like us obviously suffer.