Episode 3 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...

POLICE!

..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, a travel insurance cheat gets a one-way ticket to jail.

Mr Gordan's criminality, as far as I'm concerned,

currently stands at one of the most prolific fraudsters

that I've managed to come into contact with.

A badly-executed motor claim runs out of gas.

Unfortunately, they hadn't got their story straight.

One talked about it happening in the afternoon,

and the other one said it happened in the evening.

That's not possible.

And a false injury demand gets the treatment it deserves.

It didn't actually happen.

You'd get thrown further off your seat if you had hiccups.

Holidays should be a time to kick back and relax,

but if the break starts to breakdown then travel insurance is there,

whether you need help during or even before the holiday.

Unlucky Umesh Gordan's holiday never even got off the ground.

He had to cancel his entire trip after having paid in advance

for flights and accommodation.

He submitted a claim for a medical condition which meant he couldn't

go on his holiday and it was in the region of £4,500.

Mathew Crawford-Thomas is Intana's Fraud Manager.

Intana is a claims management specialist handling claims

on behalf of insurers.

The company required Gordan to back up his claim

with relevant paperwork.

All the documentation that he'd submitted to us appeared legitimate.

PHONE RINGS

But then, a chance conversation led Mathew to seriously question

the claimant's version of events.

It was an off-the-cuff remark I made to a fellow fraud expert

that enlightened me that Mr Gordan had actually submitted a claim

in 2004 for very similar or the same circumstances.

Maybe Gordan was incredibly unfortunate

when it came to summer holidays.

Either way, Mathew decided to take a closer look at the details.

Flights on all occasions for all the claims that we'd found were

all legitimate flights with various airlines.

So far so genuine,

but it turned out that Gordan was winging it with the air travel.

He was prepared to lose a little amount of money,

anything between 80 to £150 on those flights because the accommodation

that he was purportedly booking was absolutely and 100% fake.

The flight tickets may have been real,

but the accommodation bookings,

which made up the bulk of the compensation pay-outs,

were forged, as was the other paperwork.

Mr Gordan submitted bank statements and medical certificates

that, on the face of it, were legitimate.

However, further investigations found out that these documents

were, in fact, totally fraudulent.

As far as Mathew was concerned, Gordan had never had any intention

of going away and had never been ill.

Membership of the Insurance Fraud Investigators Group allowed Mathew

to widen his investigation into Gordan.

His findings were explosive.

I uploaded data into their system of the fraud that I'd found

for Umesh Gordan.

This uncovered fraud dating back to 2004 with 28 claims

for nine insurers amounting to over £113,000.

This was jumbo-sized insurance fraud.

Every single claim from 2004 to 2011

was for the exact same modus operandi.

He sustained an injury and/or illness.

All the doctors stamps were stamped by exactly the same doctor.

These dodgy medical certificates were submitted

to prove he was too unwell to go on holiday.

The sickening scale of his fraud meant investigators started

to look into his background.

They subsequently found out that he actually worked for

Leicester City Council Benefits Department.

We then secured his holiday record for the period that we knew

he was committing insurance fraud

and it subsequently transpired that he didn't, in fact, have the

right amount of time booked off for the holidays in question.

Far from being too ill to go on holiday, this proved Gordan

had been well enough to work his normal nine to five in the office.

Mathew wasn't prepared to let Gordan just walk away

from his travel insurance con.

To find such an array of fraud dating back over such a long period

of time, I felt that it was personal and needed to be brought to justice.

I personally wrote 28 statements, which totalled over 60 pages.

With such a weight of evidence,

Mathew's next move was to present his findings to IFED, the City

of London Police's Insurance Fraud Enforcement Department.

They arrested Mr Umesh Gordan, at which point

he denied all criminality and said that it had looked like someone

had either stolen his identification or actually stolen his laptop.

Trying to portray himself as a victim was just one more

deception, but Gordan had reached the end of the road.

Upon further investigations of his laptop

they found a drive with a big note on there saying insurance claims,

it was at that point that Mr Gordan, I believe, gave up the ghost.

Having worked to exorcise the fraud from the start,

Mathew was there in person to see the conclusion of the case.

I attended Leicester Crown Court for the sentencing of Mr Umesh Gordan.

Justice was finally served in the £113,000 swindle.

The judge gave him two years due to the fact that he had actually

admitted fraud sooner rather than later.

He is currently at Her Majesty's Pleasure.

Mr Gordan's criminality, as far as I'm concerned, currently

stands at one of the most prolific fraudsters that I've

managed to come into contact with.

Bearing in mind what he did for a living, for him to submit

such a large amount of claims to the industry for such an elongated

period of time is... it beggars belief, to be brutally honest.

As does the decision to risk his successful career

and reputation by committing fraud.

It just goes to show that no matter what you do for a job,

people are always prepared to commit insurance fraud

if they think they can get away with it.

But not on my watch.

Later...

Bus CCTV puts the breaks on a claim for multiple serious injuries.

Do you see any contact with an eye or ribs of either of these

people on the bus?

No, it, cos it didn't happen.

And justice is delivered to a postal fraudster.

Mr Coburn was quite upset after his arrest

and I think that's probably because there was such damning

evidence that we recovered on his computers.

Recent figures show that there were nearly 150,000 road traffic accidents

reported last year in Great Britain.

Clearly, some fraudsters think they can slip in a false claim

unnoticed.

But without a watertight cover story their chances are sunk from the beginning.

Ursula Jallow is LV's Head of Financial Intelligence

and Crime Solutions.

Ursula's team recently investigated a claim from a Mr Williams who said

he'd been involved in an incident with an LV customer, Mr Lee.

We had a call from Mr Williams to let us know that

he'd had an accident.

He explained it was a significant one and that it happened

at a crossroads where he'd collided with a third party.

Mr Williams was driving east in his Vauxhall.

Driving south was Mr Lee in his BMW.

At a set of crossroads, it was alleged that both cars collided.

As further details emerged, it became clear that LV was dealing

with an extremely high value claim.

Within both of those cars at the time of the accident

they alleged they both had three passengers each, so we actually

had a total of eight personal injury claims as part of this claim.

As a result of that, our actual total claim

by the end of our investigation was around £500,000.

That is a significant amount of money.

It certainly is, but right from the start there were

doubts about the £500,000 claim.

A couple of things that absolutely didn't add up about this claim

were, based on what was described, it was a significant accident...

..with extensive damage.

We had no witnesses and we had no emergency services called.

That's unusual.

You're telling me. Unusual if not suspicious.

With the amount of money on the line,

further investigation was needed and a forensic engineer was appointed.

Insurers use forensic engineers for a number of things, but mainly

actually to clarify what happened in the event of an accident.

They can tell by looking at the car

whether the damage is consistent with the circumstances that

have been described, and in this case they absolutely weren't

consistent with what we were told about the accident.

The location of the damage on the cars was significant.

The circumstances that were given

meant that the damage had to be on one side.

The left-hand side of Williams' car

and the right-hand side of Lee's car.

Actually, having investigated and looked at the vehicles,

the damage was on the opposite side of where it should have been.

As shown on the photos.

If that wasn't suspicious enough,

there was also a major question mark over Lee's car.

The vehicle at the time was not even driveable.

There was a significant transmission problem

and therefore it wouldn't have even been able

to drive let alone being involved in an accident.

The claimants were clearly trying to send LV in the wrong direction

with a fake story about an accident that never happened.

Further evidence then emerged about the undriveable car.

We identified that actually Mr Lee's car had previously been

involved in an accident that caused exactly the same damage to the

vehicle that was now in our claim.

What a coincidence.

For a car that couldn't be driven it was apparently getting around a lot.

That claim was actually turned down with the other insurer

because he'd failed to disclose some modifications about the car

at the policy inception.

So the previous claim had hit the skids too.

LV went back to the claimant to get his side of the story.

When we spoke to Mr Lee about the information that we'd

found about the previous accident, he still absolutely denied

any knowledge of that accident happening.

More inconsistencies emerged when the passengers who were

supposedly in the cars at the time were interviewed.

Unfortunately, they hadn't got their story straight.

One talked about it happening in the afternoon,

and the other one said it happened in the evening.

That's not possible.

In fact, nothing about the claim was possible, and it showed.

This wasn't the most sophisticated.

Their stories didn't match up, the cars weren't even

driveable at the time of the claim. It just really was shoddy.

LV was determined to take the case further.

It was very clear that we needed to do a bit more

than just not pay the claims.

They referred the case to the City of London Police's

Insurance Fraud Enforcement Department

and the officers interviewed some of the people

who'd supposedly been in the cars.

Three of the claimants confirmed that actually the accident

didn't take place and their claims were absolutely fraudulent.

These three were given cautions

but the case against the five other men went to court.

Williams, the driver of the car insured with LV,

received eight months,

and Lee, the owner of the undriveable car got 12 months.

LV were really pleased with this result.

It's not OK to commit a fraudulent claim, and as a result

of doing that you will be found out and you will be put in prison.

DI Dave Hindmarsh of the Metropolitan Police's

Roads and Transport Policing Command heads up an elite team of officers

who combat vehicle crime.

If you are convicted then you must expect

that you will receive a custodial sentence.

For all the millions invested in technology to detect

insurance fraud, sometimes you can't beat good old-fashioned

police work, like in this case.

It came to us from one of our uniformed officers

who was out on the street.

He'd been doing routine patrols when he stopped the car.

The car was registered to a London driver,

in fact it was registered to the person who was driving it

but the insurance policy was registered up north in Daventry,

with our driver who was stopped at the time as a named driver.

The car was ultimately not insured so it was seized.

But this wasn't the end of the story, not by a long way.

Several days later, the same officer stopped another car

virtually in the same circumstances in that it was a London car

with a London driver, however the insurance policy

was for an address in Daventry,

again with this person as a named driver.

Either a lot of drivers were moving from Daventry to London

and forgetting to update their details

or something more sinister was going on.

The officer who stopped the second car

was immediately suspicious and started questioning the driver

as to how they had obtained their insurance policy

and that had come through in an advert on an online market site.

The driver said that the advert was for an insurance broker,

someone who, for a fee, uses their know-how

to find cheap insurance for a client.

It can be a legitimate business

but when it's fraudulent, it's known as ghost broking.

The ghost broking scam works because they offer cheap insurance.

Maybe it's to people who

are high-risk drivers, multiple penalty points on their licence etc,

and you will provide your details and the cash and you

will not know what the ghost broker then sends to an insurance company.

All you can be sure of is that the ghost broker will change

small details so the quote from the insurer is cheaper

than a policy with all the correct information.

The significance of these two policies which highlighted

this ghost broker both being in Daventry is simply it is

a lower insurance premium, it's a lower risk area.

The difference would be hundreds of pounds between a policy taken

out in London and a policy taken out in places such as Daventry.

To the unwitting customer, it appears that the broker has got them

a much cheaper deal, even with the fee.

The results of the investigation into the online advert

provided the breakthrough that led to the next stage of the case.

We were happy that we'd established through our various intelligence

indices where the advert had been placed and who had placed it.

That person was Milad Ahmed.

In early 2013, Dave and his team moved in to shut down his fraud.

Right, this morning we're off to an address in east London.

Dave and the team arrive before dawn to execute the search.

Raids are always scheduled early to ensure that the suspect is home.

Just keep cover on the rear, would you?

It's important to guard the exits,

in case a suspect decides to make a run for it.

Once everyone is in position,

the officers are ready to make their move.

Morning, police. Can you open up, please? Good morning.

The occupier's let us in so we'll just be explaining why we're

there and hopefully we'll start a search in the next few moments.

Although cameras didn't gain entry to the property during the search,

it proved very fruitful.

The significance of the items that were found on that search

showed that the computer equipment had been used

to take out policies of insurance

for various people, so a really key piece of evidence for us.

After the search, the equipment was forensically examined

and conclusively linked Ahmed to the fraud.

His motor insurance con had finally stalled and the next stop was court.

He pleaded guilty, purely on

the strength of the evidence that we had uncovered.

He received five months' imprisonment.

As far as Dave is concerned,

the sentence sends out a strong message to would-be ghost brokers.

It's illegal, you can't do it and if you are convicted then you do

stand the risk of going to prison.

FirstGroup's buses carry around 1.7 million people every day

and passenger safety is a huge priority.

Lee Ingram works for Transportation Claims,

which handles claims for FirstGroup.

Every accident that results in a personal injury case

against the company is thoroughly investigated

but not everything is as it seems at first glance.

It was alleged in early September 2014 that two ladies had been

thrown from their seats due to a bus braking heavily.

This was in reaction to a car in front

that had stopped to turn right.

According to the claim,

the women had suffered multiple serious injuries.

The injuries alleged were soft tissue injuries to the neck.

One of the ladies was alleging an eye injury.

There was an exacerbation of a pre-existing spinal condition,

some injury to the ribs.

All of these sort of injuries would be commensurate with being

thrown around a bus into the metal parts of the bus,

the poles and the seats in front.

The value of the claim was therefore considerable.

Both of these claims combined would have

been in around about the £20,000 mark and that would have

covered the injuries themselves, the loss of earnings, treatment fees

and also the legal bills arising from bringing the claim.

According to FirstGroup's records, the incident was real enough.

No-one's denying that this is

a genuine situation where a bus driver has had to brake heavily.

So we've established that something has happened.

The next thing we need to do is to prove

whether the ladies' injuries have been caused by this incident.

FirstGroup buses are fitted with multiple CCTV cameras

so the next logical step was to check

the recording from the day of the incident.

All seemed normal at first.

So what we're seeing is a nice journey through what looks like

a sort of countryside-type area.

The women in question are sat in the top right of the frame.

When I'm reviewing the footage, I'm expecting to see something

like a zero gravity space transmission, with bodies flying

around in slow motion, ricocheting off the inside of the bus.

"Expecting to see" being the operative phrase.

The emergency stop is coming up, which supposedly

resulted in multiple injuries to the women.

There's definitely an incident there. The bus has had to brake.

The passengers on the top deck

and the driver can be seen reacting to the sudden braking.

So let's see what happened to the two women.

If what they claimed occurred is true,

you're about to see something distressing.

Brace yourselves.

Oh, was that it? Am I missing something?

According to the women, the incident had caused multiple serious injuries

to the neck, eye, ribs and spine,

but the footage put a very different spin on things.

There's nothing like what what's actually been said.

There's no sign of these two ladies being

thrown from their seats as has been alleged.

We've got claims for rib injuries, eye injuries. Do you see any

contact with a eye or ribs of either of these people on the bus?

No, cos it didn't happen so this footage, it's just great

in that it totally refutes anything that they're saying has happened.

No matter how many times you look at it, there's no way the footage

shows an impact that could have resulted in multiple injuries.

There's certainly no eye injury, although they may

want their eyes tested if they think the footage backs up their claim.

Their case is further undermined several minutes later when they

reach their stop, get off the bus and stroll away seemingly without

a care in the world and showing absolutely no signs of injury.

To make themselves seem more legitimate, the women had

taken on legal representation.

I quote from one of the solicitor's comments,

"The force of the braking threw the claimant off her seat."

That's utter bobbins. It didn't actually happen.

You'd get thrown further off your seat if you had hiccups.

It was hard to swallow that the claim had come in at all.

Naturally, we sent the CCTV footage to the claimant's solicitors.

In most cases, that brings everything to an abrupt halt.

Unusually, we did actually receive a reply back this time

saying that the claims were withdrawn.

That's all very well and good but it would be nice sometimes

to just get a response saying, "I'm sorry for wasting your time."

I've been doing this job for 28 years

and that's never happened yet but a man's gotta have a dream.

One day, Lee, one day.

Ordinarily, when something you send through the post goes missing,

it's irritating, but if your whole business relies

on posting products to clients it could be disastrous.

Missing post is something that Royal Mail takes very seriously.

They've been providing a first class service delivering our letters

and parcels for the last 500 years so when they heard about

multiple postal losses affecting one person they set up an investigation.

Royal Mail receives around 90 claims for compensation of mail

relating to mail being sent by a Mr Milan Cockman

being sent to various addresses throughout the world.

Well, he was claiming that the items were actually lost in the post.

The claimant was involved in an online business

which entailed supplying memory modules for digital storage.

But there was a major problem that was affecting the business.

According to him, almost every order he sent out was going missing...

..and he was having to claim back compensation from Royal Mail.

Because of the high volume of claims that were made by Mr Cockman,

Royal Mail Customer Services down in Plymouth

have a separate investigation team

and they raised their concerns with myself, saying that the

price that he was claiming, £50 per packet,

and he'd been paid around £4,700,

was excessive so then I took on the investigation from there.

With such a large sum of money being delivered into his bank account,

suspicions were raised.

The investigation turned to the paperwork

supplied by the claimant in support of each of the 90 pay-outs.

I looked at the invoices and they appeared to be scanned.

This was immediately cause for concern as claims

require original documentation.

The investigation then turned to the high value products being sent out.

I then contacted the company where Mr Cockman alleged that he'd

bought them from and they confirmed that the memory module

value is in fact around £6 or £7 and not £50.

Was it possible that someone involved in memory storage

could just forget the price of the product?

I also looked on the internet myself

and again found that you could buy these memory

modules for around £6, £7, not the £50 as Mr Cockman had claimed.

By inflating the price by eight times the true value the claimant

was posting a huge profit from the compensation pay-outs.

Having gathered proof of the fraud, I then contacted an inspector,

a police inspector, and arranged for the arrest of Mr Milan Cockman.

We searched Mr Cockman's home address

and we recovered a number of computers which were

forensically examined by Royal Mail, Royal Mail's forensics team,

and we also recovered a number of invoices which showed

the actual amount Mr Cockman had paid for each of the memory modules.

But the strongest evidence was, naturally, stored away digitally.

Mr Cockman was quite upset after his arrest

and I think that's probably because there was such damning evidence

that we recovered on his computers.

The case had fraud stamped all over it,

and the claimant was eventually taken to court.

Mr Cockman was found guilty of all the charges under the Fraud Act,

he was sentenced to four weeks imprisonment which was

suspended for 18 months, 180 hours unpaid work

and had to pay compensation of £2,500 to Royal Mail.

The result of the trial sent out a strong message.

Royal Mail were very satisfied with the outcome of the case

and I think it shows that we will prosecute for every fraud offence.