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 billion every year.
0:00:08 > 0:00:11That's almost £3.5 million every day.
0:00:13 > 0:00:16Deliberate crashes, bogus personal injuries,
0:00:16 > 0:00:18even phantom pets.
0:00:19 > 0:00:23The fraudsters are risking more and more to make a quick killing,
0:00:23 > 0:00:27and every year it's adding over £50 to your insurance bill.
0:00:27 > 0:00:29But insurers are fighting back,
0:00:29 > 0:00:33exposing just under 15 fake claims every hour.
0:00:33 > 0:00:35Armed with covert surveillance systems...
0:00:35 > 0:00:38Subject out the vehicle.
0:00:38 > 0:00:40..sophisticated data analysis techniques...
0:00:42 > 0:00:45..and a number of highly skilled police units...
0:00:45 > 0:00:47Police, don't move, 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 > 0:00:55All those conmen, scammers and cheats on the fiddle are now
0:00:55 > 0:00:58caught in the act and claimed and shamed.
0:01:05 > 0:01:09Coming up, one musical mailman's insurance claim is
0:01:09 > 0:01:11far from first-class.
0:01:11 > 0:01:14I would have thought it was very difficult for Mr Masumbu to
0:01:14 > 0:01:18go all the way to Malaysia, to go on a stage and play a guitar.
0:01:19 > 0:01:23CCTV cameras capture the performance of a lifetime.
0:01:23 > 0:01:26As a high level estimate on the value of the injury,
0:01:26 > 0:01:29we would have placed that at around about £2,500-£3,000.
0:01:29 > 0:01:32DOG BARKS
0:01:32 > 0:01:36And Agria think they might be dealing with a shaggy dog story.
0:01:39 > 0:01:42We could find no evidence that these puppies ever existed.
0:01:50 > 0:01:53In January 2012, the police joined the fight against insurance
0:01:53 > 0:01:57fraud by launching an elite squad known as IFED.
0:01:57 > 0:02:00IFED is Insurance Fraud Enforcement Department,
0:02:00 > 0:02:03which is based in the city of London, but is countrywide.
0:02:03 > 0:02:07IFED is involved in all sorts of insurance fraud,
0:02:07 > 0:02:09notably for vehicles, personal injury or slip and trip.
0:02:09 > 0:02:11We cover the whole spectrum.
0:02:12 > 0:02:14They've made over 700 arrests
0:02:14 > 0:02:18and have saved millions of pounds in fraudulent insurance claims.
0:02:20 > 0:02:23Money which ultimately goes back in our pockets.
0:02:23 > 0:02:27From now on, fraudsters need to watch their backs.
0:02:27 > 0:02:30You carry out fraud, we will follow you and we will arrest you
0:02:30 > 0:02:32and we will convict you. We will take everything you gained
0:02:32 > 0:02:35and give it back to the people who you've robbed.
0:02:39 > 0:02:42Over 600,000 of us are injured at work each year.
0:02:42 > 0:02:45But working as a postman for the national treasure that is
0:02:45 > 0:02:48the Royal Mail isn't generally considered one of
0:02:48 > 0:02:50the most hazardous of jobs.
0:02:50 > 0:02:52You might deliver to the wrong house,
0:02:52 > 0:02:57or at worst be on the receiving end of a particularly nasty dog bark.
0:02:57 > 0:02:59But if we're to believe one former postman,
0:02:59 > 0:03:03the risks of the job can be life destroying.
0:03:03 > 0:03:06Mr Masumbu was at work when he went to the back of the van,
0:03:06 > 0:03:09opened the sliding door and took out some parcels,
0:03:09 > 0:03:11and while he was there, someone driving behind skidded
0:03:11 > 0:03:14on the wet road and slammed in the back of him.
0:03:14 > 0:03:16CRASH
0:03:16 > 0:03:19As a result of the accident, Mr Masumbu sustained bruising
0:03:19 > 0:03:21to his torso and upper body...
0:03:22 > 0:03:25..leaving him physically unable to work.
0:03:25 > 0:03:27During the course of the following months, he went
0:03:27 > 0:03:31and sought medical advice and was examined.
0:03:31 > 0:03:33He couldn't dress himself properly,
0:03:33 > 0:03:36he couldn't live a normal life, in fact.
0:03:36 > 0:03:40He actually stated to the doctor that his life was over.
0:03:40 > 0:03:45After the accident, Mr Masumbu received £25,500 in compensation.
0:03:45 > 0:03:49But with life-changing injuries, he was also potentially in line
0:03:49 > 0:03:52to receive a six figure pay-out from the insurance company
0:03:52 > 0:03:55should his claim be settled.
0:03:55 > 0:03:58However, with a claim of this scale, before handing over any more
0:03:58 > 0:04:03money, the insurers wanted to check a few facts.
0:04:03 > 0:04:08Before any pay-out, an insurer will make an assessment
0:04:08 > 0:04:10and do their own investigations.
0:04:10 > 0:04:14In this day and age, many people love to share what they've been up
0:04:14 > 0:04:16to by posting it on the internet.
0:04:16 > 0:04:20But unfortunately for Mr Masumbu, investigators discovered one little
0:04:20 > 0:04:24nugget online that I'm sure he would have preferred to have kept quiet.
0:04:26 > 0:04:30They looked at a blog and this was a blog from the Malaysia music
0:04:30 > 0:04:34festival, which shows Mr Masumbu on stage playing a guitar.
0:04:37 > 0:04:39Just to be clear, that's him on the right.
0:04:41 > 0:04:43Let's have a look at that again.
0:04:46 > 0:04:49Surely a man in your condition shouldn't be strumming
0:04:49 > 0:04:51the guitar with such gusto.
0:04:51 > 0:04:52You could put your back out.
0:04:52 > 0:04:55I would have thought it'd be very difficult for Mr Masumbu to
0:04:55 > 0:04:59get all the way to Malaysia, to go on a stage and play a guitar.
0:05:02 > 0:05:05The insurers, of course, were pretty suspicious of Mr Masumbu.
0:05:08 > 0:05:12But jetting off to Malaysia wasn't the only travelling he was doing.
0:05:12 > 0:05:15Investigators discovered that Mr Masumbu had been
0:05:15 > 0:05:19involved in yet another car accident and was driving at the time,
0:05:19 > 0:05:23which is something he'd told the medical examiner he couldn't do.
0:05:23 > 0:05:27They put a surveillance team behind Mr Masumbu to watch if he was in
0:05:27 > 0:05:32fact, as he said he was, someone who was restricted in their movement.
0:05:33 > 0:05:37Yet again, when investigators saw the footage the surveillance team
0:05:37 > 0:05:40had captured, they couldn't believe their eyes.
0:05:43 > 0:05:47The surveillance footage showed Mr Masumbu getting in and out
0:05:47 > 0:05:51of his car outside his home address with bags of shopping,
0:05:51 > 0:05:54a guitar and other instruments,
0:05:54 > 0:05:57and walking quite freely to and from his home address.
0:05:57 > 0:06:00That looks like an awfully big box to be carrying for a man who
0:06:00 > 0:06:03claims he struggles to walk.
0:06:03 > 0:06:05Seemed to be walking perfectly all right,
0:06:05 > 0:06:09not impaired, and he certainly wasn't walking with a stick.
0:06:10 > 0:06:12Hang on, I thought you said you couldn't drive.
0:06:12 > 0:06:15You want the passenger side.
0:06:15 > 0:06:20It was now that there was grave doubts as to Mr Masumbu's claims.
0:06:20 > 0:06:23And he was called in for a further medical
0:06:23 > 0:06:25examination for his injuries.
0:06:27 > 0:06:30But when Mr Masumbu arrived, the miracle cure that had
0:06:30 > 0:06:31enabled him to drive again
0:06:31 > 0:06:36and rock out on stage with his guitar appeared to have worn off.
0:06:36 > 0:06:38Strange, that.
0:06:38 > 0:06:43He came in walking very badly with the use of a stick,
0:06:43 > 0:06:47and in fact needed the help of the doctor to undress
0:06:47 > 0:06:49so the examination could take place.
0:06:49 > 0:06:54By now, the doctor was aware of the possibility that the claim
0:06:54 > 0:06:58was bogus and during the examination could find no injuries
0:06:58 > 0:07:02consistent with Mr Masumbu's status at that point.
0:07:03 > 0:07:06Sounds like this postman's claim form needs to be sent
0:07:06 > 0:07:08back to the sorting office.
0:07:09 > 0:07:13Mr Masumbu did have injuries as a result of his accident,
0:07:13 > 0:07:16but they were very minor in comparison to what he'd
0:07:16 > 0:07:19actually alleged and which had paid out for.
0:07:19 > 0:07:22By now, it was clear that Mr Masumbu had been seriously
0:07:22 > 0:07:26exaggerating the severity of his injuries, and with hundreds
0:07:26 > 0:07:30of thousands of pounds on the line, the case was referred to IFED,
0:07:30 > 0:07:33who wasted no time in delivering the bad news to their suspect.
0:07:35 > 0:07:40Mr Masumbu was arrested in the early part of 2014. The full facts
0:07:40 > 0:07:45were put to him, including the video footage. Mr Masumbu denied that the
0:07:45 > 0:07:50claim that he'd made was false, and stuck to his story throughout.
0:07:52 > 0:07:56However, his argument didn't stand up and IFED hit Mr Masumbu with two
0:07:56 > 0:08:00charges of fraud, before he appeared at the Old Bailey to face the music.
0:08:03 > 0:08:07Mr Masumbu, faced with the overwhelming evidence against him,
0:08:07 > 0:08:10could do nothing else but to plead guilty.
0:08:11 > 0:08:15Masumbu was ordered to repay the £25,500
0:08:15 > 0:08:19he'd already wrongfully received from his £300,000 claim...
0:08:19 > 0:08:22and was sentenced to 18 months in prison.
0:08:22 > 0:08:27I don't know what made him turn to crime apart from greed.
0:08:30 > 0:08:34He'd a perfectly good job and a good pension and a good lifestyle.
0:08:34 > 0:08:37He chose to do something different, he took the wrong choice,
0:08:37 > 0:08:39and now he's spending 18 months in prison.
0:08:48 > 0:08:52Still to come, two puppies go walkies, apparently.
0:08:52 > 0:08:56If I'd got two new family members and they'd gone missing,
0:08:56 > 0:08:58I'd be out looking for them.
0:08:58 > 0:09:01- And FirstGroup take a sure-footed approach.- We did go back to them
0:09:01 > 0:09:05and say, "We have no intention of making any payments in this.
0:09:05 > 0:09:07"If you want to get anything else from us, you're going
0:09:07 > 0:09:08"to have to sue us."
0:09:14 > 0:09:17Whilst the majority of insurance claims are legitimate
0:09:17 > 0:09:20and deserving of pay-outs, insurers in the UK uncover
0:09:20 > 0:09:23a whopping 350 cases of fraud every day.
0:09:25 > 0:09:30Thankfully, public liability experts like Rob Smith-Wright from QBE are
0:09:30 > 0:09:35on hand to identify the claims that are more opportunistic than honest.
0:09:35 > 0:09:37Although, as Rob knows only too well,
0:09:37 > 0:09:42some bogus claimants trip themselves up with their own stupidity.
0:09:42 > 0:09:44The circumstances that a claimant reported to us
0:09:44 > 0:09:48was that he was on his way to a local pub
0:09:48 > 0:09:52and was using our policyholder's car park as a short cut through.
0:09:52 > 0:09:55As he was walking through the car park, he's tripped over in a
0:09:55 > 0:09:59pothole and suffered soft tissue injuries to his ankle and foot.
0:09:59 > 0:10:02As a high level estimate on the value of the injury,
0:10:02 > 0:10:06we would have placed that at around about £2,500-£3,000.
0:10:07 > 0:10:10Luckily, the company who own the car park had a CCTV camera
0:10:10 > 0:10:15rolling at the time. It sounds like a particularly nasty accident
0:10:15 > 0:10:17so viewer discretion is advised.
0:10:17 > 0:10:21The CCTV evidence showed the claimant
0:10:21 > 0:10:24entering the car park,
0:10:24 > 0:10:27it showed him walking across the car park.
0:10:27 > 0:10:30And quite visible in the CCTV, and would have been to anyone
0:10:30 > 0:10:33walking there, would have been two potholes.
0:10:35 > 0:10:38He then stops, turns around, walks back
0:10:38 > 0:10:41and walks back straight in the direction of the pothole.
0:10:41 > 0:10:44As he gets to the pothole, he steps into it
0:10:44 > 0:10:47and then falls quite theatrically to the floor.
0:10:47 > 0:10:49Quite theatrically?
0:10:49 > 0:10:52I've seen pantomime dames more convincing than that.
0:10:53 > 0:10:58It's at that point that we realised that this was a fabricated incident.
0:10:58 > 0:11:01As you can see, the claimant walks into the car park,
0:11:01 > 0:11:05and the CCTV quite clearly shows the pothole is visible.
0:11:05 > 0:11:08I've got to see that again. Can we rewind it?
0:11:11 > 0:11:14OK, so he comes in, mind the hole, son...
0:11:14 > 0:11:17Phew. Danger avoided.
0:11:17 > 0:11:20Does a u-turn. Hang on...
0:11:22 > 0:11:24And he's down.
0:11:25 > 0:11:28More like a feather than a tonne of bricks, to be fair.
0:11:28 > 0:11:31Come on, get yourself up now.
0:11:31 > 0:11:34Come on. Go on, you can do it.
0:11:34 > 0:11:36OK, this chap's really milking it now,
0:11:36 > 0:11:39but I'll give him his due, he is committed to the role.
0:11:41 > 0:11:43A picture paints a thousand words, and this,
0:11:43 > 0:11:47this footage absolutely identifies to us that this was
0:11:47 > 0:11:51a fabricated incident and should not be worthy of compensation payment.
0:11:51 > 0:11:55And it soon became obvious that this chap's case was full of potholes.
0:11:55 > 0:11:59There was no short cut through this car park to the local pub
0:11:59 > 0:12:01that the claimant was visiting.
0:12:01 > 0:12:04We also established that the claimant had been
0:12:04 > 0:12:06living in the area for nine years
0:12:06 > 0:12:09and therefore he will have known this.
0:12:09 > 0:12:12We also established that the particular local pub that he
0:12:12 > 0:12:14was going to visit wasn't actually open at the time he was
0:12:14 > 0:12:16walking through the car park either.
0:12:18 > 0:12:23As far as QBE were concerned, this actor's audition was over.
0:12:23 > 0:12:28We made a referral of this case to IFED, the Insurance Fraud Enforcement Department.
0:12:28 > 0:12:32He admitted that he did indeed fabricate the incident.
0:12:32 > 0:12:34His reasons were he was short of money
0:12:34 > 0:12:38and he wanted some extra funds.
0:12:38 > 0:12:43He was of previously good character, so he was given a caution.
0:12:43 > 0:12:47So, if anyone out there thinks they can trip up insurance companies,
0:12:47 > 0:12:50remember, it's more than likely that you'll be the one to fall
0:12:50 > 0:12:51flat on your face.
0:13:01 > 0:13:05Africa, with its breathtaking scenery, bustling cities
0:13:05 > 0:13:07and diverse wildlife.
0:13:07 > 0:13:11It's one of the most beautiful continents in the world.
0:13:11 > 0:13:15But for one woman, it was the scene of a nightmare.
0:13:15 > 0:13:18Fortunately, travel insurers CEGA were on hand to
0:13:18 > 0:13:19help during this difficult time.
0:13:21 > 0:13:24The customer contacted our emergency assistance helpline to
0:13:24 > 0:13:25advise us that
0:13:25 > 0:13:30while she was visiting her husband in Nigeria, he'd sadly passed away.
0:13:30 > 0:13:34We naturally offered the customer our sincere condolences.
0:13:34 > 0:13:36We then explained to her that we would do everything
0:13:36 > 0:13:40we could to assist her at this difficult time.
0:13:40 > 0:13:43She now wanted our assistance in returning home early.
0:13:43 > 0:13:48This wasn't a particularly high-value claim, around £700.
0:13:48 > 0:13:52At least with CEGA on hand to help, she wasn't going through this
0:13:52 > 0:13:53horrific ordeal alone.
0:13:55 > 0:13:59In order to assist the customer, we do need various documents to
0:13:59 > 0:14:01substantiate the claim. The customer provided us
0:14:01 > 0:14:05with a death certificate for her husband and also provided us with
0:14:05 > 0:14:10details of the doctor that treated her husband before his sad passing.
0:14:10 > 0:14:14With everything they needed, CEGA began to process the claim.
0:14:14 > 0:14:18We asked our in-house medical team to contact the doctor to find out
0:14:18 > 0:14:22exactly what happened leading up to her husband's death.
0:14:22 > 0:14:25But it was at this point that things got suspicious.
0:14:25 > 0:14:29Our in-house medical expert spoke with the doctor,
0:14:29 > 0:14:32but came away from the call thinking that they weren't actually
0:14:32 > 0:14:34speaking with a genuine doctor.
0:14:34 > 0:14:37What made them jump to that conclusion?
0:14:37 > 0:14:41The alleged doctor couldn't even understand any basic medical terms.
0:14:43 > 0:14:46A doctor who doesn't know his knees from his kidneys,
0:14:46 > 0:14:47just a bit worrying.
0:14:47 > 0:14:50But surely the death certificate would be enough proof.
0:14:50 > 0:14:53Due to the international nature of our business, we're well
0:14:53 > 0:14:56versed in knowing what original
0:14:56 > 0:14:59and genuine documents actually look like, particularly death
0:14:59 > 0:15:03certificates, and on this occasion, the death certificate didn't conform
0:15:03 > 0:15:07to the normal standards we would expect for this type of document.
0:15:08 > 0:15:11Concerned, CEGA decided to check the death certificates with
0:15:11 > 0:15:14the hospital where it supposedly came from.
0:15:14 > 0:15:17Our investigator was then referred to the medical directorate,
0:15:17 > 0:15:21who proceeded to write a statement for our investigator,
0:15:21 > 0:15:23confirming that the death certificate was a false
0:15:23 > 0:15:27document and didn't ever originate from their hospital.
0:15:27 > 0:15:31It appeared that CEGA were dealing with a phantom fatality,
0:15:31 > 0:15:35and by now, the woman's claim was in a critical condition.
0:15:35 > 0:15:38We were particularly shocked at what lengths the customer had gone to
0:15:38 > 0:15:41to try and make this fraudulent claim.
0:15:41 > 0:15:45We decided to e-mail the customer and highlight what our concerns
0:15:45 > 0:15:48were with her claim, and invited her comments.
0:15:48 > 0:15:50As we didn't receive a response from the customer,
0:15:50 > 0:15:53we formally declined the claim.
0:15:53 > 0:15:55The claim was well and truly dead and buried,
0:15:55 > 0:15:58and the claimant was incredibly lucky to walk away.
0:15:59 > 0:16:02Is it really worth potentially getting a criminal
0:16:02 > 0:16:05record for the sake of £700?
0:16:17 > 0:16:20We all trip up and take a tumble every now and then.
0:16:20 > 0:16:22But usually we pick ourselves up,
0:16:22 > 0:16:24dust ourselves down and hope nobody saw.
0:16:26 > 0:16:29But sometimes falls can result in nasty injuries,
0:16:29 > 0:16:32as Lee Ingram from FirstGroup discovered when he dealt with
0:16:32 > 0:16:36a claim from a woman who'd been injured at a train station.
0:16:36 > 0:16:39The initial allegations from the claimant were that she'd
0:16:39 > 0:16:42slipped on a piece of wet cardboard just inside the entrance
0:16:42 > 0:16:45of the station and this had caused her to fall over and hit her head.
0:16:45 > 0:16:48Ouch, that does sound painful.
0:16:48 > 0:16:51The injuries sustained were quite serious. She'd knocked herself
0:16:51 > 0:16:55out, so she was unconscious and she had a really bad cut to her head.
0:16:55 > 0:16:57This claim would have been worth around about £18,000,
0:16:57 > 0:17:01so that would have covered the injury itself, treatment fees
0:17:01 > 0:17:05and replacement of the clothing, and legal costs on top of that as well.
0:17:05 > 0:17:09FirstGroup take personal injuries very seriously,
0:17:09 > 0:17:12so the first thing they did was investigate the woman's claim.
0:17:12 > 0:17:15But from the off, something didn't ring true.
0:17:15 > 0:17:18The very fact that she'd said that cardboard had been
0:17:18 > 0:17:21put down to soak up the water was a little bit unusual. I mean,
0:17:21 > 0:17:25when people are trailing wet footprints in bad weather,
0:17:25 > 0:17:28through stations, you wouldn't put cardboard down, you would send out
0:17:28 > 0:17:33a clean-up crew to try and make sure that any excess water was removed.
0:17:33 > 0:17:36Far from happy with the woman's description of the incident,
0:17:36 > 0:17:38Lee and his team set about cleaning up this claim,
0:17:38 > 0:17:42and the first step was to try and establish what really did happen.
0:17:44 > 0:17:47We thought we'd go back to our client, get the CCTV
0:17:47 > 0:17:50and surveillance footage and see what else we could find out.
0:17:52 > 0:17:55Fortunately, when we're looking at railway footage, they've got static
0:17:55 > 0:17:58cameras and they tend to cover most of the station, so you can
0:17:58 > 0:18:02pretty much plot someone's passage throughout the whole of the station.
0:18:02 > 0:18:06But when Lee examined the footage, it painted a rather different
0:18:06 > 0:18:09picture to the one the claimant would have FirstGroup believe.
0:18:12 > 0:18:16What we noticed from the CCTV is that the incident clearly doesn't
0:18:16 > 0:18:20happen just inside the entrance to the station, that's not true at all.
0:18:20 > 0:18:23This is a covered station, the floors don't look wet,
0:18:23 > 0:18:28there's no signs of the alleged cardboard that she's tripped on.
0:18:28 > 0:18:32So, with the CCTV clearly showing no wet patches on the floor,
0:18:32 > 0:18:36and certainly no cardboard, what really did happen?
0:18:36 > 0:18:39We'll see her pause at the top of one escalator, and you think,
0:18:39 > 0:18:41"Right, she's a little bit wary of escalators,
0:18:41 > 0:18:44"that's quite normal, quite a few people are."
0:18:44 > 0:18:48I can see those metal steps aren't filling her with confidence.
0:18:50 > 0:18:53When she comes to go up the next escalator,
0:18:53 > 0:18:57she pauses for some 22 seconds before she actually plucks up
0:18:57 > 0:18:59the courage to get on the escalator.
0:19:00 > 0:19:04She eventually goes up about four steps and then she just takes
0:19:04 > 0:19:07a really hard fall backwards.
0:19:07 > 0:19:09It's clearly a genuine accident.
0:19:09 > 0:19:13She has taken a nasty tumble. You can see she's hit her head on the way down.
0:19:13 > 0:19:16She's landed just in a heap on the escalator.
0:19:17 > 0:19:20Luckily for this poor woman, the public and station staff
0:19:20 > 0:19:23were there to help her back to her feet.
0:19:23 > 0:19:25She really does hit her head on the way down,
0:19:25 > 0:19:28and you can understand, that's a metal tread as well.
0:19:28 > 0:19:30So that's going to make a nasty whack,
0:19:30 > 0:19:32you can see why she's knocked out.
0:19:33 > 0:19:36There's no disputing that this was a nasty accident,
0:19:36 > 0:19:39and thankfully the woman recovered from her injuries.
0:19:39 > 0:19:43Looking at this, you can clearly see she's just lost her footing and fallen backwards.
0:19:43 > 0:19:47She's lied about the circumstances. No-one's to blame for that,
0:19:47 > 0:19:49it's just an unfortunate accident.
0:19:50 > 0:19:53FirstGroup sent their CCTV evidence off to the claimant's
0:19:53 > 0:19:59solicitors to prove once and for all that there was no soggy cardboard.
0:19:59 > 0:20:01So we, we've sent the footage back to her solicitors,
0:20:01 > 0:20:04we've pointed out there's no tripping hazard,
0:20:04 > 0:20:06as was alleged. They've then come back to us
0:20:06 > 0:20:10and said, "We made a mistake, it was actually a wet floor she slipped on."
0:20:10 > 0:20:13The floors weren't wet, that's not true at all,
0:20:13 > 0:20:15as you can see from the footage.
0:20:15 > 0:20:17As far as Lee was concerned, it was what the woman
0:20:17 > 0:20:21and her solicitors weren't saying that spoke volumes.
0:20:21 > 0:20:23I think the key point here is that, all
0:20:23 > 0:20:25the way along, we've got an allegation of a slip on a wet
0:20:25 > 0:20:30floor. Never have they mentioned an escalator.
0:20:30 > 0:20:34Armed with concrete evidence from the CCTV cameras, FirstGroup
0:20:34 > 0:20:38took a robust stance and flat out refused to settle the claim.
0:20:38 > 0:20:41The solicitors did want to carry on with this claim.
0:20:41 > 0:20:42But we did go back to them
0:20:42 > 0:20:45and say, "We have no intention of making any payments in this.
0:20:45 > 0:20:48"If you want to get anything else from us, you're going to have to sue us."
0:20:48 > 0:20:50They've never come back to us on that.
0:20:50 > 0:20:53So it looks like they've accepted what we were saying.
0:20:53 > 0:20:56So, for any would-be claimants out there
0:20:56 > 0:21:00who think they can lie about an accident, Lee has a message.
0:21:00 > 0:21:03Where there's a situation where we've caused something to happen,
0:21:03 > 0:21:06we would really like to get those claims dealt with,
0:21:06 > 0:21:10compensate people for what they're entitled to.
0:21:10 > 0:21:12In situations where they're going to make things up, though,
0:21:12 > 0:21:17and they're just not true, we're not going to make payments on those.
0:21:17 > 0:21:20With more and more cameras watching our every move, potential
0:21:20 > 0:21:23fraudsters need to watch their step.
0:21:29 > 0:21:33There are 8.5 million dogs around the country, and for many of us,
0:21:33 > 0:21:37they're more than just pets, they're part of the family.
0:21:37 > 0:21:40Thankfully, insurers are there to help protect our furry little
0:21:40 > 0:21:42friends during their time of need.
0:21:42 > 0:21:45Good morning, Kennel Club Pet Insurance, you're through to
0:21:45 > 0:21:47Megan, how can I help?
0:21:47 > 0:21:48So, when a dog owner called up
0:21:48 > 0:21:52to report the theft of two puppies worth £3,000,
0:21:52 > 0:21:54Simon Wheeler's team were more than happy
0:21:54 > 0:21:56to get their paws into the claim.
0:21:56 > 0:21:59The first we heard from the claimant in this case was that he'd
0:21:59 > 0:22:01had two bulldog puppies stolen.
0:22:01 > 0:22:06He'd come down early in the morning and the padlock on his garage door
0:22:06 > 0:22:10had been broken and the two puppies stolen.
0:22:10 > 0:22:14There weren't really any alarm bells that gave our claims handlers
0:22:14 > 0:22:17any inkling that there might be problems with this claim.
0:22:49 > 0:22:52Eh? Did he just say he's about to go on holiday?
0:23:09 > 0:23:12Now, for me, if I'd got two new family members
0:23:12 > 0:23:15and they'd gone missing, the last thing I would do is go on holiday.
0:23:15 > 0:23:17I'd be out looking for them, I'd be panicking
0:23:17 > 0:23:20and doing everything possible to try and find them.
0:23:20 > 0:23:22It doesn't sound to me
0:23:22 > 0:23:26as though the owner is exactly missing his furry pals too much.
0:23:36 > 0:23:40Hang about, you're telling me you've just spent three grand
0:23:40 > 0:23:43on a couple of puppies and didn't chip them? So much for puppy love.
0:23:46 > 0:23:48With all these question marks hanging over the claim,
0:23:48 > 0:23:51investigators got on the dog and bone.
0:23:51 > 0:23:53When we began our investigations, the first thing
0:23:53 > 0:23:57we discovered was that neither puppy had ever been seen by a vet.
0:23:58 > 0:24:01As there were no leads on the dog's whereabouts,
0:24:01 > 0:24:04investigators turned to technology to dig a little deeper.
0:24:04 > 0:24:06It was very evident the policy holder was an avid
0:24:06 > 0:24:10user of social media, there were postings everywhere.
0:24:10 > 0:24:14But, surprisingly, no mention that he'd acquired two puppies,
0:24:14 > 0:24:18no mention that they'd been stolen and very little coverage,
0:24:18 > 0:24:21certainly no pictures of those puppies.
0:24:22 > 0:24:25When pushed further, he came up with a single picture of two
0:24:25 > 0:24:28bulldog puppies. They could have been any old bulldogs.
0:24:51 > 0:24:55OK, so let me get this right. The puppies have apparently never
0:24:55 > 0:24:58been to the vets, have never been microchipped
0:24:58 > 0:25:02and the owner doesn't have a single photo of him with the dogs.
0:25:02 > 0:25:04It's not looking good for this chap, but I'll give him his due,
0:25:04 > 0:25:06he doesn't give up easily.
0:25:31 > 0:25:34But no matter how many times he called, there was
0:25:34 > 0:25:37no chance Agria were going to roll over on this one.
0:25:38 > 0:25:41By the time we'd exhausted
0:25:41 > 0:25:44most of the avenues of trying,
0:25:44 > 0:25:48and established that the puppies existed, the policy holder was
0:25:48 > 0:25:52getting quite, quite aggressive with our claims handlers.
0:25:52 > 0:25:57But it was all to try and establish and verify his claim.
0:26:14 > 0:26:17I think he might have hit the nail right on the head.
0:26:17 > 0:26:20So, after trying very hard over a long period of time,
0:26:20 > 0:26:23over successive phone calls,
0:26:23 > 0:26:26we could find no evidence that these puppies ever existed.
0:26:26 > 0:26:29He'd made a right dog's dinner of this claim.
0:26:42 > 0:26:45The policy holder's response to the decline of the claim was that he
0:26:45 > 0:26:49would take our decline letter and take it to the solicitors.
0:26:49 > 0:26:50We never heard from him again.
0:26:57 > 0:26:59And finally, proof that a pretty face
0:26:59 > 0:27:02doesn't guarantee model behaviour.
0:27:03 > 0:27:06Meet Shawna Lynn Palmer.
0:27:06 > 0:27:09But her gorgeous smile hides an ugly secret.
0:27:09 > 0:27:13Just two days before entering this beauty pageant,
0:27:13 > 0:27:15she told her employers that she was claiming
0:27:15 > 0:27:19compensation for an injury she'd suffered while working as a clerk.
0:27:21 > 0:27:24According to her statement, she'd fractured her toe
0:27:24 > 0:27:27so severely that she couldn't put any weight on her foot or
0:27:27 > 0:27:29wear shoes for any length of time.
0:27:32 > 0:27:34So she shouldn't have been able to parade around,
0:27:34 > 0:27:36yet alone wear these.
0:27:40 > 0:27:43So, either her commitment to world peace allowed her to smile
0:27:43 > 0:27:48through the pain, or there was something fraudulent going on.
0:27:48 > 0:27:51With lots of videos from the pageant on social media,
0:27:51 > 0:27:53Shawna's employers were soon onto her.
0:27:55 > 0:27:57The compensation claim was given the boot,
0:27:57 > 0:28:01Shawna was ordered to pay 6,000 and given 50 hours community
0:28:01 > 0:28:06service, proving that while she may have been blessed with beauty,
0:28:06 > 0:28:09the brain side of things need a bit more work.