Episode 1 Claimed and Shamed

Insurance fraud in the UK has hit epidemic levels.

It's costing us over £1 billion every year.

That's almost £3.5 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 just under 15 fake claims every hour.

Armed with covert surveillance systems...

Subject out of 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.

KNOCKS AT DOOR

The City of London Police's Insurance Fraud Enforcement Department

pays a visit to a suspected fraudster...

He wasn't expecting a knock.

He wasn't expecting anyone, I don't think,

to catch up with what he'd been up to.

..a brazen bus claim is busted...

She may as well have been sitting on the bonnet of the car

with her feet up, reading the newspaper,

wearing a T-shirt saying, "I'm not in my car".

..and a claimant is their own worse enemy.

Everyone who works in insurance

should know what a hard line the industry takes against fraud -

from junior claims handlers up to high-flying City brokers,

like Jay Solder.

Solder's generous salary

meant he frequently jetted off on luxury holidays.

But one sunshine break ended up under a black cloud

and he had to make a claim.

He'd lost his jacket whilst on a flight

coming back from a European destination.

Contained within his jacket was a pen, mobile phone,

wallet and some cash.

Mathew Crawford-Thomas is the fraud manager at Intana,

a company that's a claims management specialist,

handling claims on behalf of insurers.

The claim Mr Solder submitted to us in May 2013

was in the region of between £4,000-4,500.

On the basis of it, the claim looked 100% genuine.

But Solder's travel claim was the start of a journey

that would lead all the way to court.

As soon as I opened up the documents for Mr Solder's claim,

alarm bells started to ring.

I recognised the name "Jay" and the occupation "insurance broker".

To have that first name and that occupation the same...

to me, seemed a bit strange.

Mathew soon discovered it was no mere coincidence.

After a bit more digging, I'd actually found out

that he'd submitted a claim to us in January of the same year.

This time, under the name "Jay Webb".

But Jay Solder hadn't stopped at a fake name.

I ran the date of birth through our system

and found a match at a completely different address -

the same first name, different surname,

same bank account, same occupation.

For me, the two claims were from exactly the same person.

Not only was there a close match on the personal details,

there were other similarities too.

Most of the items that he'd claimed for in January 2013

and in May 2013 were exactly the same items.

It was unfortunate for Mr Solder -

he thought he was dealing with two different companies.

However, both claims landed on my desk, albeit four months apart.

Convinced that there had never been a loss

and that the whole thing was fabricated,

Mathew liaised with IFED...

..the City of London Police's

Insurance Fraud Enforcement Department -

and they launched an investigation,

headed up by DC Aman Taylor.

One of the main enquiries I did was to contact the airlines,

to find out if he actually flew

and it transpired that, on one of the flights, he hadn't flown.

He'd bought the cheapest ticket he could find from Stansted to France

and used the boarding pass as proof of him flying.

With the evidence building,

Solder's holiday scam was about to be permanently grounded.

By now, we were certain something wasn't right

and that we needed to go round and speak with Mr Solder officially.

We rocked up to the house at 7.30 in the morning

and began to give the IFED knock on the door.

Eventually, Solder opened the door

and let the officers into his property.

-I'm from the City of London Police Insurance Fraud team.

-Right.

I'm here today to speak to you, regarding a claim that you've made.

-Is it all right if we come in?

-Yeah.

-Got my colleagues here with me.

'First thing we do in that circumstance is to arrest him.'

You're under arrest on suspicion of fraud by false representation,

relating to the claim that's been made. I've got to caution you,

you do not have to say anything, but it may harm your defence if you do not mention when questioned

something which you later rely on in court. Anything you do say may be given in evidence.

When Jay Solder was placed under arrest, he was visibly shaking. 'He wasn't expecting a knock.

'He wasn't expecting anyone, I don't think, to catch up with what he'd been up to.

I can see you're upset about it, but unfortunately,

-this is the way it's going to have to be dealt with today.

-OK.

-All right?

And then we went about our business searching,

to try and find the items that he'd claimed for -

especially given the fact that we knew, on one of the travel claims,

he hadn't even travelled.

If the evidence they found was related to the claims,

it would prove vital.

Good.

No, nothing.

We like to be thorough in IFED.

Bathroom's clear.

There's sunglasses which are...

They're similar, they're the same make and model of the sunglasses

that have been reported stolen as well.

So, we'll seize them.

Lo and behold, items that Mr Solder had claimed for

were located at the property.

See that? There, look.

And that's going to be the camera lens.

There's one item in particular, which was a Sony camera,

which featured in a lot of the claims,

along with a number of other items which were matched,

or similar items to ones that had been reported stolen.

Still to come, the raid continues.

I'll have to get this down. I think this is a bag of money.

And more - much more - comes to light.

£6,000 is not something you usually come across

in your normal house search.

And words fail when CCTV reveals a false claim.

There aren't enough syllables in the word "incredulous"

to describe how I actually felt when I looked at this.

I just wanted to, to scream at the screen saying,

"She's not in the car!"

More and more, the insurance industry

is relying on technology to detect fraud -

from large-scale cons right down to minor household claims.

What these scammers all have in common

is that they underestimate the sophisticated resources available.

Good afternoon, you're speaking to Claire at I-COG. How can I help?

On the surface, this claimant seemed to be making

a fairly routine household insurance claim.

But the claimant had dug a hole for himself

with the shady gardening story.

It was quite unbelievable that it's just an unexplained loss.

The rings had just vanished from the property.

Whilst the back door had been open,

their eyesight had been in the property at all times.

There was no way these rings

could just have disappeared from this kitchen.

Claire Mitten, from specialist claims consultants I-COG,

worked on the case.

The insurance company wanted Clare to use her expertise

to root out any inconsistencies in the claimant's version of events.

We asked him to forward us any proof of ownership he might have,

in the form of a receipt, a valuation,

as well as a photograph.

He submitted a photograph of his wife wearing the rings,

but was unable to provide us with any receipts or valuations.

But rather than burying any suspicions,

the photo planted further seeds of doubt.

When we received the photograph, to the untrained eye,

it would look like a very normal photograph -

it was a lady on her sofa

with her arm around the dog, cuddling the dog.

However, to us, as experts in the industry,

we were able to tell that this photograph looked quite staged.

The prominence of the photograph was on the ring

and it was quite close up, with regards to what we were looking at.

Just didn't feel quite right.

But that wasn't all.

Further technological analysis of the photo revealed evidence

that proved beyond doubt that it was a totally false claim.

We analysed the photograph

and the data that was held within the photograph and established

that the photograph had actually been taken the evening before.

The incident date had actually been the previous week,

so this quite clearly led to the fact

that he still had the rings in his possession.

It was time to raise the concerns with the claimant.

Claire rang him and gave him the opportunity to come clean.

With the claimants pleading ignorance,

Claire knew it was time to confront him about the dates.

But it didn't go the way she expected.

Yesterday?

I'm no advanced conversation management expert,

but he just dropped himself in it.

If he'd lost the rings when he said,

he couldn't possibly have taken a photo of them yesterday.

This did surprise me.

I wasn't expecting this result. I was expecting him to explain

that they were taken quite a long time ago.

I actually don't think he realised what he had told me.

Come on, pal. You're fooling no-one.

He wasn't budging, but Claire's not one to back down.

I then asked the insured for a final time

that this was his chance to be honest with me

and tell me what had happened to the rings.

With the photo evidence and the confession,

there could be only one outcome to the claim - it was declined.

We explained to him that

the insurance company has zero tolerance to fraud

and we have recommended that the insured

is placed on the fraud register.

So, it'll make it very difficult for him in the future

to get any further insurance policies.

Right from the start, the tale of lost jewellery

had lacked the ring of truth.

And by the end of the call,

Claire had successfully weeded out the facts.

Digital data from photographs was also instrumental

in a case of wintry woe submitted to Allianz.

-NEWS PRESENTER:

-Britain's brutal winter remains with us.

In early 2014, Britain's notoriously unpredictable weather

meant the country took a battering.

The UK was hit by a series of weather-related events -

mini-storms, if you will.

And thousands of policy holders were affected.

Lives were affected, businesses were affected.

Given the situation, there was nothing immediately unusual

about one particular weather-related claim.

The policy holder had suffered storm damage

to the rendering on a wall outside his house.

The damage was estimated to be in the region of £3,900-4,200.

Allianz started to process the claim

and commissioned a surveyor's report.

It was at this point that the storm clouds started to gather.

In his view, the damage was caused by wear and tear

and over a period of time than actually being storm damage.

The foundations of this claim were starting to look shaky

and Allianz contacted the builder

who had provided one of the estimates.

He also indicated that the damage was likely to be

as a result of moisture over a period of time,

as opposed to a single event, such as a storm.

But could the policy holder simply have been mistaken

about the cause of the damage?

The policy holder's occupation was a builder...

..and one would expect a builder to be able to differentiate

from what is storm damage to what is wear and tear.

Unlikely, then.

Further investigation was called for

and they took another look at photos

that had been supplied with the estimates.

The analysis of the photographs told us

that the photos weren't in fact taken at the time alleged,

but were taken three and a half months earlier.

And it was at this point that we thought, actually,

we were dealing with a fraudulent claim.

Allianz's investigation cut through the bluster

to expose a bitter truth.

The policy holder knew

at the time of incepting the policy with Allianz Insurance

that there was pre-existing damage

and he was simply waiting for the opportunity

for a weather-related event to submit the claim.

When the storm struck, he saw his chance

and attempted to claim an insurance pay-out.

Challenged by Allianz about the photos,

he refused to come clean and the case was passed to IFED.

Some months later, we were contacted by IFED,

who advised us they'd arrested the policy holder.

He'd admitted the fraud and they'd given him a caution.

Although they'd avoided an undeserved pay-out,

there was still a cost to bear.

What was really frustrating about this whole thing

was that the policy holder submitted a claim at a time

when there were thousands of policy holders in genuine need

and this diverted resources from Allianz, from other insurers,

where we could have actually helped those people get back on their feet.

This does prove that insurance fraud is not a victimless crime.

According to the Association of British Insurers,

whiplash is now costing motorists £2 billion a year.

Aviva's bodily injuries unit, based in Bishopbriggs near Glasgow,

includes experts that specialise in detecting personal injury fraud.

If someone tries to fake or exaggerate an injury,

they'll pull the plug.

Richard Hiscocks is Director of Casualty Claims.

His team recently dealt with an injury

caused by a road traffic collision.

So, we got a claim from the third party,

to say he'd been involved in an accident with our customer.

He was holding our customer at fault.

The accident was two cars reversing in the early hours of the morning,

outside a nightclub.

The claimant had alleged that, as they were reversing,

our customer had reversed into him, causing injury.

THUD!

He claimed that he had whiplash in his left shoulder,

of 12 months' duration.

With such a lengthy period of injury,

the value of the claim was substantial.

We put an estimate on this claim of just over £5,000,

which is a mix of the compensation for the injuries

and the legal costs.

But right from the start,

there was something back to front about the claim.

Aviva contacted their insured driver

and his version of what had happened was very different.

He was acquainted with the claimant

and they'd been reversing their cars at the same time.

I don't quite know why they'd been doing that.

Me, either!

Because the contact and the speed was very slight...

..they both agreed at the time

that neither was going to do anything more about it.

But some time later, the claimant did a U-turn on the agreement

and put in a claim.

He even attempted to back it up with CCTV he'd obtained.

Actually, what you see is two vehicles reversing at the same time.

Our customer's in the white vehicle on the right-hand side,

the claimant is in the other vehicle next to that

and they seem to reverse together

and, right at the end, there's some sort of collision,

but clearly, the CCTV shows there's no impact

that's severe enough to cause injury.

Submitting the CCTV was a bold move,

but one that ultimately backfired spectacularly.

This CCTV was provided by the claimant in support of their claim,

but actually, what it does is pretty much disprove it.

Aviva informed the claimant that they would not be paying.

He refused to back away and the case went to trial,

where he couldn't even keep his story straight.

Originally, he said that he had

a 12 month injury to his left shoulder.

In court, he said he had

a six months injury to his right shoulder

and he had injury to his neck, which hadn't been mentioned before.

So, he'd changed his shoulder and added something else in

and changed the duration,

which clearly indicated he was fabricating much of his story.

The outcome was never really in doubt.

The judge found in our favour. Not only did we win the case,

that there was no injury, he also found that

the claimant was what's called "fundamentally dishonest",

in that he'd fabricated evidence, which the court takes a dim view of.

And it was good old CCTV

that put the brakes on the false personal injury claim.

FirstGroup operates a fleet of over 6,000 buses

carrying around 1.7 million passengers a day.

So, it's not surprising that, from time to time,

there are minor accidents.

In 2010, one of our London buses has been rounding a corner.

He's taken the corner a little bit too tight

and he's managed to come into contact with a vehicle

that was parked at the side of the road as he's gone round the bend.

We've received a claim for the damage to the vehicle

and then, some time later,

we've been presented with a personal injury claim

from the lady with the car.

According to the claimant, this was no minor prang,

but a collision that resulted in serious injury.

This claimant's alleged that she was in her vehicle with her seatbelt on

when she was hit in the rear by a bus.

She's been thrown forwards and backwards,

and also been thrown into the interior of her car,

striking her chest.

This has caused her some problems

with general household heavy domestic chores -

hanging out her washing -

the injury itself is mainly to her shoulder.

Treatment involved physiotherapy

and, subsequently, it may well end up in surgery.

The level of injury was reflected in the potential value of the claim.

All in all, this claim would have been worth around £42,000.

That's the injury itself, the surgery costs

and, after surgery, you may well need some looking after,

so we would allow an element of care for that as well

and just about under half of it

would have been legal costs on top of that.

Most people would have assumed the woman had suffered a serious injury

and FirstGroup was responsible.

But Lee's not most people,

and, right from the off, he knew something was amiss.

Normally, in an incident where a vehicle is shunted in the rear,

you've got a forward-backward movement,

so you would expect a sort of whiplash-type injury.

With this particular one, the main injury is to her shoulder.

That, coupled with the fact that she didn't actually go and see her GP

until some four months after the accident,

just made us think, "Something's not quite right here".

So, we immediately thought we would investigate this in a bit more depth

and it was at that stage that we decided to look at the CCTV footage.

What it showed put a huge dent in the claimant's story.

So, we look up the CCTV from this incident.

We're expecting to see an impact on the vehicle,

we know that's happened. There's damage to the car.

The bus is rounding the corner, it does hit the car,

so this lady's alleging she's been thrown around in her car,

she's been moved forward and backwards.

There's the glaring, obvious fact that she's not in the car.

She's standing by the side of the car -

it's absolutely ridiculous!

There aren't enough syllables in the word "incredulous"

to describe how I actually felt when I looked at this.

I just wanted to scream at the screen saying,

"She's not in the car!"

It's just absolutely preposterous

that she could even consider putting this claim in.

She may as well have been sitting on the bonnet of the car with her feet up,

reading the newspaper, wearing a T-shirt saying, "I'm not in my car".

It's just so blatantly obvious, when you look at it.

With the CCTV proving that no injury had occurred,

the prognosis for the claim was not looking good.

We sent the CCTV footage to the claimant's solicitors,

pointing out the major flaws in their client's case

and, unsurprisingly, we've not heard back from them since.

I think even the best solicitor in the world is going to have a problem

making a claim for personal injury

in a car accident where someone wasn't actually even in the car.

I'm from the City of London Police Insurance Fraud team.

Previously, DC Aman Taylor began a search of the home of Jay Solder,

an insurance broker suspected of

trying to defraud his own industry.

So, at the moment, I've just to tell you, you're under arrest, OK?

You're under arrest on suspicion of fraud by false representation,

-relating to the claim that's been made, all right?

-OK.

They've already found a camera

that featured in several insurance claims.

-He's got an active policy at the moment.

-With somebody else?

That's not the one that he had with us.

But the search is about to uncover something completely unexpected.

Two more holidays booked.

Two more claims.

A little interesting development here -

that our policy, which wasn't paid out on,

which is the one that Mat's investigated and passed on to us -

the one that he's been nicked for today -

he's actually got another policy in place at the time...

-That covers the same trip.

-..covering the same trip.

During the search, we found another travel insurance document

for another claim that had been made by Mr Solder

and found that to be an entirely fraudulent claim as well.

So, the first claim he made with my mob,

which got paid, I can check.

Right.

That's the reason why he's walked away from that one -

due to the fact that this policy covers the same trip,

that he bought two policies for.

-Yep, so he's gone on that when he's got a knock back from them.

-Yeah.

It was the search that kept on giving.

We found a large quantity of cash,

which subsequently turned out to be around £6,000 in cash,

which had been concealed in a wardrobe.

And we found a Rolex watch

valued somewhere in the region of about £8,000.

-Yeah, looks nice, doesn't it?

-Is there a story behind this, Jay?

It was replaced by the insurance company.

So what, have you had a loss or a theft of one of these before, then?

-Yeah, in the first burglary.

-Oh, OK.

-So, this is the replacement?

-Yes.

Right, OK.

Following the off-the-cuff remark made by Mr Solder

about the Rolex being a replacement following a burglary,

I decided to dig a bit deeper and contact the insurance companies

to try and find out whether or not he had been burgled

and whether or not he had been paid out.

What we found was that he'd not had one,

but he'd had two home insurance claims - with one company.

Both made within three months of each other

and totalling over £50,000.

This was a huge new development in the case.

In addition to the travel insurance claims they knew about,

it appeared that Solder had branched out into household insurance,

claiming a staggering amount of money for two burglaries

they strongly suspected had never happened.

The raid was a total success, as far as we're concerned.

We got the person we were looking for,

we seized all the items that we were looking for,

with the addition of some items that we weren't aware of at that time.

Meanwhile, Jay Solder was given the opportunity

to tell his side of the story.

Jay Solder didn't admit to his crimes.

The first interview we had at the police station,

he answered "no comment" to all of our questions.

And, in the second interview,

he was given full disclosure of all the evidence that we had against him

and he still elected to make no comment.

Solder's silence on the matter ultimately made no difference

and the case proceeded to court at the Old Bailey.

He admitted four fake travel insurance claims

and two exaggerated household claims.

He then had to return to be sentenced

and Aman was there to see justice served.

He was terrified, really -

terrified of what was going to happen.

He knew the gravity of the fact

that it's such a serious offence, over a period of time.

Solder was called in to hear his fate.

It wasn't good news.

Today, he's been sentenced to 21 months in prison.

The judge has the option to suspend it,

which he has done in these circumstances.

160 hours of community service,

so giving something back to the community.

And he's been ordered to pay back £37,000.

For Aman, it's the end of a long, complex investigation.

Today, I'm satisfied with the outcome -

the outcome is one where we brought an end to the case,

so it shows that we'll see it the whole way through.

While Solder avoided a custodial sentence,

there's still a heavy price to pay.

Jay Solder's a young man in a very good job.

By committing this insurance fraud, he's pretty much ruined his life.

My advice to anyone that considers committing this type of crime

is to simply not bother.

You will get found out, it will get detected

and you could end up standing in front of an Old Bailey judge,

waiting for a sentence to be passed.