Episode 10 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 the vehicle.

..sophisticated data analysis techniques...

..and a number of highly skilled police units...

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

..they're catching the criminals red-handed.

Just don't lie to us.

All those conmen, scammers and cheats on the fiddle

are now caught in the act and claimed and shamed.

Today, an insurance scam takes its toll.

These families have been broken due to their involvement in this fraud.

A dubious home insurance claim fails to get off the ground.

She then quite bizarrely suggested

that two crows had entered her property

upon two separate occasions and caused very similar damage.

Pretty implausible, really.

And a fake personal injury claim takes a tumble.

Once we'd looked at the CCTV footage,

he just didn't have a leg to stand on.

Fraudsters seem to think

that making a false claim involves little or no risk.

But lying on legal documentation or in court

actually carries a heavy penalty,

as insurance cheats are increasingly finding out.

Ursula Jallow,

LV's Head of Financial Intelligence and Crime Solutions,

worked on a case in which a taxi driver

claimed that his car had been hit by one their policy holders.

Jamil was driving along the road,

when our insured pulled out onto Mr Jamil's taxi.

SCREECHING TYRES

The resulting collision meant that the taxi driver

was claiming for compensation.

The claim was for Mr Jamil himself from an injury perspective,

the damage to his vehicle, hire of a temporary car and storage.

In addition to that, he was actually carrying two passengers

at the time, who both also put personal injury claims through.

In total, the claim that was put forward totalled £145,000.

Maybe he'd left the meter running. It was a staggering amount of money

for what sounded like a fairly minor collision,

involving him, his passengers - Farhana Kazami and Shamila Saleem -

and an LV-insured driver.

Further investigation was called for.

At LV, we have a number of indicators that tell us

if we should be looking into a claim that might be suspicious of fraud.

In this case, there were a few indicators that were met.

Things like having a claim come through very close to

when the policy is set up, which is what happened in this case.

As we carried out further investigations,

we found that actually, the addresses that had been provided

as part of the claim and also mobile phone numbers had also been

used in very similar claims across the industry with other insurers.

And actually, we got in contact with some of those insurers and found

that actually, the claims were very, very similar

and were definitely connected

and therefore we actually had an organised fraud ring.

If they were right, they'd uncovered criminality on a huge scale

involving multiple people and collisions.

Ronan McCann, from law firm Horwich Farrelly,

also worked on the case for the insurers affected.

Initially he focused on the suspicious addresses

and the people who supposedly lived there.

It was my view that these policy holders didn't exist

and when we had investigators going to these properties,

they were able to discover that they did not.

But to move the investigation up a gear,

they also needed to test Mr Jamil's version of events.

To find out what really happened, we sent out a forensic engineer.

He identified that actually, the damage to the vehicle

wasn't consistent with the circumstances

presented to us as part of the claim.

In addition to that, he was able to understand

that at the time of the accident, despite the third party saying

that he was driving along, actually, the car was stationary at the time.

And that was quite damning.

The forensic engineering evidence drove away any doubts.

At this stage, it became clear to me what really happened.

The organisers of this fraud had secured the cooperation

of a number of different individuals and had taken their vehicles away,

driving one into the other when one of them was stationary.

And it wasn't just the LV collision where the cars were proved to

have been stationary at the time they sustained the damage.

This was a great piece of evidence

which was common to each individual case.

So we then were able to build up a picture of this fraud ring

and were able to see that the common features

included the damage to the vehicles,

the fact that they were stationary when damaged,

the fact that the policy holders didn't reside

at the properties that were given.

It was my view that these claimants,

having signed witness statements, claim forms,

were telling lies.

The insurers agreed and refused to pay out.

We did decline the claims but actually,

the claimants then issued proceedings against us

for their losses.

So, is that a surprise?

Actually, to the insurance industry, that's not.

That's something we see every day,

especially when it's organised fraudsters.

Driven on by greed, they seemed to think

that they can use the law to intimidate companies

into giving them money.

Legal action is an attractive route for fraudsters,

because if they win, they get a payout,

and if they lose, there's no comeback.

Or at least, that's what Mr Jamil

and his associates, including Kazami, assumed.

Ronan thought differently.

I recommended to the insurance company

that instead of simply allowing claimants to discontinue,

that we proceed with a separate application

to transfer the matter to the High Court

and to seek to pursue them in contempt of court

by way of a prosecution, which could result in a jail term.

The tables were about to be turned on the fraudsters

and they would now be the ones being pursued through the courts.

With the stakes raised, there was a surprising development in the case.

Unusually, I received a telephone call from Farhana Kazami,

one of the claimants involved in the LV claim.

She telephoned me to say

that she was really sorry for being involved,

that the claim was in fact dishonest,

and what should she do.

To that, I confirmed to her that she should simply tell the truth,

send a letter to the court,

or a statement to the court and to myself.

I said that would have the effect

that the court may well be more sympathetic.

She took his advice and made a full confession.

A sentence from her letter puts this into context.

"I am truly sorry for what I've done and the time that has been wasted.

"I've wanted to come clean ages ago

"and was scared of the consequences."

True to her word, she then stuck to her honest version of events

under the pressure of cross-examination.

She stood firm and confirmed that this accident was staged,

that she wasn't involved in it,

and that she was apparently going to get one third of the money.

She made a credible witness and in the end,

the three others - Saleem, Jamil and Aziz - admitted the charges.

For falsely trying to claim £145,000,

they were hit with a combined total of 22 months in prison.

Farhana Kazami, who had been quite courageous,

was handed a 12-week sentence, which was suspended for six months.

The much smaller sentence reflected her honesty.

There is a very sad side to this story,

which is a human cost.

All the fraudsters were parents and, in some cases,

were the sole breadwinners for their families.

These families have been broken due to their involvement in this fraud.

They were the authors of their own misfortune

and this really sends out a message to anyone getting

involved in fraudulent claims to stay well away.

Later, a phone claimant's story lacks the ring of truth.

And a shocking injury leads to a bogus compensation claim.

That's the point where his leg has snapped

and the bone is probably on the outside of his body by now.

Queues, over-crowding and cancelled trains.

All part of the commuting experience for the 4 million people

who use public transport to get to work in England and Wales every day.

As if that's not bad enough,

one man recently got home to discover

that he'd lost his phone during the journey.

Andy Morris is the chief marketing officer for Assurant Solutions,

a company that provides cover for mobile devices.

We received a call from this particular claimant.

They had lost a high-specification iPhone.

It was only later that he realised he'd lost the phone.

In line with standard procedure,

the case was reviewed by the company's claims handlers.

We have a unique sort of fraud-scoring system,

which will identify

trends or likelihoods or people

who have a propensity to submit a false claim.

Well, this particular claimant was a little bit vague,

which is not uncommon for people when they've lost their phone.

The claim was flagged as needing further investigation

and the fraud team interviewed the man in more detail.

He sounds pretty certain,

but it turns out his faulty memory has let him down again.

But the absent-minded claimant was forgetting something else.

Something very important.

One of the amazing things about this case is the evidence

that we obtained was that the claimant was advertising for sale,

on an online sales site, the same phone,

exactly the same specification with the same contact details,

personal contact details they'd submitted for the claim form.

Despite the claimant's vague response,

the situation was crystal clear.

The phone that he was claiming a payout for was also on sale.

The suspicion was that he'd never lost it

and that he was attempting to get a double payout.

Our fraud team telephoned this customer to question, you know,

was there any mitigation, or was there a reason for it.

The claimant had informed our agent

that somebody had stolen their identity.

Double whammy. According to the claimant,

they'd lost their phone and their identity had been stolen.

But shortly afterwards, his run of bad luck and memory loss ended.

We were unexpectedly contacted three days later by the claimant,

who said there was no further action necessary,

that amazingly, they had found the original phone

and that they no longer needed our services.

It was an incredible twist of fate.

As soon as he'd been informed

the claim wasn't going to go any further,

the phone in question turned up and the claim was dropped.

If you're thinking about defrauding because it's just £500

or it's just a little handset,

actually, it's still a financial crime.

Accidental damage to your possessions

can leave you spitting feathers.

But that's where household insurance comes in,

even if the culprit isn't human.

Scott Clayton is Zurich's Claims Fraud and Investigations Manager,

and recently dealt with a claim from a policy holder

who'd gotten into a flap.

The initial claim that came in

was that she said that she'd been woken at 6 o'clock in the morning

with a disturbance downstairs.

On going downstairs, she found out

that a crow had actually come into the property

and was trying to escape.

So in its panic and doing whatever crows do,

then it was making quite a mess in its attempts to escape.

According to the claimant,

the feathered offender had caused mayhem.

The claim was accompanied by photos,

which showed the extent of the damage,

if you look closely enough.

I mean, she said that a fireplace had been damaged by this crow,

the carpets, not just in her living room,

but in the hallway and stairs had been damaged,

which needed cleaning.

Curtains had been soiled and damaged,

a mirror had fallen off the actual wall.

When you added all the items up, it was round about £5,500.

A considerable sum, which seemingly flew in the face

of the photographic evidence.

But at this stage,

there was no reason to doubt the policyholder's word.

In Scott's experience, this type of wildlife claim

isn't a particular rare sighting.

It's actually not hugely unusual for a crow or a bird to actually

find its way into a property.

When they do find themselves cornered

and they're trying to escape,

then frequently we do get claims for the mess that they cause.

It was only on closer examination that foul play was suspected.

We investigated the claim like we normally do

and looked into the background of the policyholder

and we managed to find out that she'd actually made

several previous claims with other insurers.

So we looked specifically into one claim

because it had very similar hallmarks to this one,

and managed to establish that, sure enough,

she'd made a virtually identical claim to her previous insurers

for damage caused by a crow.

This certainly ruffled feathers with the fraud team.

They were convinced that there had never been a crow invasion

and the policyholder was attempting to bring a false claim.

We sent an investigator out to see the policyholder,

took a statement from her.

She actually denied that she'd made any previous claims for bird damage.

She denied having previous claims with other insurers,

but clearly we knew that was different.

So we ultimately challenged her on those facts

and she eventually admitted that she had made a previous claim

with another insurer for this damage.

But even then, she tried to wing it with an unconvincing explanation.

She then quite bizarrely suggested

that two crows had entered her property

on two separate occasions and caused very similar damage.

Pretty implausible, really.

Her bird-brained cover story wasn't going to fly

and there would be no payout from Zurich.

That wasn't the end of it.

She obviously knew the repercussions for what she'd done

so she, probably in an attempt to try

and make things easier for her, wrote us a letter of apology.

The letter said, "I'm very sorry for the misleading statement

"I gave to you on your visit to my home

"and I now wish to withdraw my claim and again I wish to apologise

"for any inconvenience I may have caused you and your company,

"and I do hope this will bring this matter to a close.

"I would very much appreciate this."

The case may not have gone any further,

but there are still serious consequences.

Not only did she lie to Zurich when she took the policy out,

but she lied to her previous insurer.

Although she admitted that she'd made a fraudulent claim,

it doesn't stop there

because she's going to find it very difficult

to obtain insurance in the future.

With no payout and a big question mark

against her financial prospects,

the whole saga has left the policyholder

with nothing to crow about.

If you're going to lie to your insurance company,

don't underestimate how much they collaborate

in terms of the data and information.

And if you get caught lying,

the consequences of doing that are quite severe,

either through lifestyle, employment,

or ultimately getting future insurance.

Losing your keys is normally just one those challenges

that life throws at you every so often.

But if lost keys fall into the wrong hands...

..the consequences can be severe.

Mark Chiappino is the Counter Fraud Claims and Policy Validation Manager

at Direct Line.

A customer, Mr Singh, recently got in touch to lodge

a claim for items he said had been stolen in a burglary.

We received a nine-page list from him

detailing the items that had allegedly been stolen.

This included two mobile phones, two laptops, four cameras,

the £2,000 cash and £35,000 worth of jewellery.

A nine-page list is all very well, but a high-value insurance claim

requires additional proof of ownership.

We asked him to substantiate

the amount of jewellery that had been taken,

and he subsequently e-mailed us several photographs.

These show the extent of the pilfered plunder.

The burglars were lucky to net such a large haul,

not least because, according to Mr Singh,

they gained entry to the property purely by chance.

His wife had dropped her keys in street

and the thieves had used the keys to enter his property.

This was despite the fact that there was no identifying marks on the keys

to indicate which property was his.

What a stroke of luck for the thieves.

Finding a random set of keys on the street,

locating the right house by fluke,

and then pocketing a fortune in valuables.

There was something that didn't sound quite right.

Alarm bells were ringing right from the start of this claim.

There was an unusual set of circumstances,

a high value of items had been stolen.

He was also really pushy and looking for us to settle this claim straight away.

But that simply wasn't going to happen.

With so many question marks,

Direct Line wanted to unlock exactly what had occurred with the keys.

The second time we spoke to him,

he gave us a different version of events.

The first time, he had told us

that his wife had dropped the keys in the street.

The second time we spoke to him,

he changed his story, telling us that the keys had actually

been inadvertently left in the lock when they left the house.

This merely served to confirm our suspicions

that this was a case warranting much deeper investigation.

Direct Line then analysed

the photographs that Singh had supplied.

Despite his assertion that the photographs had been taken

some time ago, they were actually date-stamped

to within a half-hour period 24 hours after he had said

the burglary had occurred.

Proving that he had the bling in his possession all along.

The whole claim and the alleged burglary had been totally fabricated

in order that he could claim £60,000 worth of money

to which he was not entitled.

Unsurprisingly, he didn't receive a penny in compensation.

After rejecting his claim, we never heard any more from this individual.

But that's not where the matter rested.

The case was passed to IFED -

the City of London Police's

Insurance Fraud Enforcement Department.

Since IFED started in 2012, we've dealt with over 1,200 people

through arrests or interviews

and we've brought over 100 people to justice in courts.

This elite squad has prevented millions of pounds being paid out

to criminals in fraudulent claims.

IFED started an investigation into Mr Singh

and the very many versions of what had happened.

Looking at all the evidence that we were given,

it was obvious to us that there had been no burglary,

this was a fairly blatant attempt

to try and carry out an insurance fraud to line his own pockets.

The next stage was for them to pay Singh a visit.

When IFED detectives went to Mr Singh's address

and arrested him and carried out a search,

we found his jewellery and his electrical items all safe and sound

inside a safe in the house.

These photos were taken on the day of the arrest.

They clearly show some of the same pieces of jewellery

that Singh had said had been stolen when he submitted his claim.

I think Mr Singh was surprised to get a knock on the door

from police detectives.

I think he thought that having had his insurance claim refused

was the end of it.

He certainly didn't expect to find himself in a police station.

Let alone court. But that's where he ended up.

When Mr Singh appeared at the Old Bailey,

he pleaded guilty to fraud

and he was sentenced to a suspended prison sentence,

100 hours' community service

and ordered to pay £1,300 in costs and fines.

His bungled scheme to gain tens of thousands of pounds in compensation

had completely backfired and he was now much worse off than before.

This was a pretty unsophisticated attempt to defraud the insurer.

There wasn't a great deal of thought put into it,

as his web of lies was pretty quickly uncovered.

It was certainly a very greedy attempt, though.

No matter how well or badly thought through the fraud is,

would-be insurance cheats need to think twice.

The industry works really closely with police units like mine

and we will come after you.

It's no secret that railway stations,

with their fast-moving trains, escalators and crowds of people

carry an element of risk.

But most people manage to avoid any drama by using basic common sense.

MOST people...

Any personal injury claims involving transportation company

FirstGroup are thoroughly investigated.

Lee Ingram is the Claims Team Manager

and recently dealt with a railway station injury.

We received a claim following an alleged tripping incident,

where a gentleman's saying that he's fallen over a defective paving slab.

According to the man, he took a heavy fall

that resulted in a horrific injury.

The claim that came in was for a compound fracture to the shin bone.

So it's one of the bigger bones in your leg.

The compound fracture element means that the bone has broken,

has actually pierced the skin.

It sounds like a pretty nasty injury, and it is.

It was no surprise, then, that the claimant was after

a substantial amount of compensation.

The value of the claim was around about £55,000,

comprising of the injury itself,

there would have been a loss of earnings claim,

a care claim arising from the fact he would have needed

help with domestic chores,

and the legal cost bills on top of that.

Lee's team decided to track down the offending paving slab,

which was said to have caused the trip.

They were expecting to find a crater.

Instead they found this.

A tiny crack, approximately three millimetres deep,

the same thickness as a pound coin.

This element of his story was starting to look groundless.

So they checked the station CCTV

to look at where on the platform the accident happened.

The man can be seen at the far end of the platform

at the top of the screen.

The defect that he's alleging is nowhere near there,

it's some 30 feet away from where he's actually saying it happened.

He doesn't even get to that part of the platform.

The man's story was starting to look shaky

and rewinding the tape even further caused it to fall down completely.

So, here comes the gentleman up to the gate

and, lo and behold, he's actually limping

when he comes into the station

so this is before the incident's even happened.

He goes through the barrier,

he's obviously in a rush to catch a train,

so he's run through the barrier as quickly as he can.

He's taken a very sharp right-hand turn and then, he stopped.

That's the point where his leg has snapped

and the bone is probably on the outside of his body by now.

He can't go on any further.

And neither could his claim.

The CCTV showed that after snapping the bone,

he could barely hobble to the nearest bench.

So, while the horrific injury was real,

the alleged reason for it happening was completely false.

The evidence in this case is particularly convincing

in the fact that it flies in the face of everything that he said.

The claimant's version of events simply didn't stand up to scrutiny,

but the real kicker was a piece of witness evidence.

Paramedics were called and they've arrived quite quickly.

This chap has actually told them

that he's injured his leg earlier that day

so he was already carrying an injury as we've seen from the footage.

Fortunately his comments to the paramedics were

witnessed by a gentleman who was working for us

but he previously worked for the Met Police for 19 years,

so a very credible witness to have overheard this particular statement.

By this stage, the man's claim had been run into the ground.

In light of the overwhelming evidence, which showed that

everything this gentleman was saying just wasn't true,

we had no choice but to turn this claim down

and, funnily enough, we've never heard back.

The claimant finally accepted that the claim had hit the buffers

and that he had only himself to blame for the injury.

I do feel sorry for the guy but, yeah, really, he shouldn't be trying

to blame us for the incident when he knows full well there was no defect.

Once we'd looked at the CCTV footage,

he just didn't have a leg to stand on.