0:00:05 > 0:00:09Insurance fraud has reached epidemic levels in the UK.
0:00:09 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:17That's almost 3.6 million every day.
0:00:19 > 0:00:24Deliberate crashes, bogus personal injuries, and even phantom pets.
0:00:25 > 0:00:29The fraudsters are risking even more to make a quick killing,
0:00:29 > 0:00:33and, every year, it's adding around £50 to your insurance bill.
0:00:33 > 0:00:36LIFT CHIMES But insurers are fighting back,
0:00:36 > 0:00:39exposing just under 15 fake claims every hour.
0:00:39 > 0:00:41Armed with covert surveillance systems...
0:00:41 > 0:00:44That's the subject out of the vehicle.
0:00:44 > 0:00:48..sophisticated data analysis techniques...
0:00:48 > 0:00:49Police!
0:00:49 > 0:00:51..and a number of highly-skilled police units...
0:00:51 > 0:00:53Police! Don't move! Stay where you are!
0:00:53 > 0:00:55..they're catching the criminals red-handed.
0:00:55 > 0:00:58Just don't lie to us.
0:00:58 > 0:01:01All those conmen, scammers and cheats on the fiddle
0:01:01 > 0:01:04are now caught in the act and claimed and shamed.
0:01:10 > 0:01:14Today, the wheels come off a bus driver's claim for compensation...
0:01:14 > 0:01:17He's doing all of the things he said he couldn't do.
0:01:17 > 0:01:20If he's driving cars around a busy carwash,
0:01:20 > 0:01:22anything could happen.
0:01:22 > 0:01:26..a thrill-seeking holiday-maker sees his case crash and burn...
0:01:26 > 0:01:29The customer then started to tell us that
0:01:29 > 0:01:30he couldn't remember what happened.
0:01:35 > 0:01:37..and a group of pretend passengers' personal injury claims
0:01:37 > 0:01:39come under scrutiny.
0:01:39 > 0:01:42That's fundamentally inconsistent and meant that we had to doubt
0:01:42 > 0:01:44whether or not the claims were genuine.
0:01:49 > 0:01:50Whether you phone-bash all day in a call centre,
0:01:50 > 0:01:53or break bricks on a construction site,
0:01:53 > 0:01:55it is an employer's legal obligation to make
0:01:55 > 0:01:58your working environment a safe one.
0:01:58 > 0:02:01If you have an accident at work that could have been prevented,
0:02:01 > 0:02:04you have the right to seek fair compensation.
0:02:04 > 0:02:08Lee Ingram is the claims team manager for First Group Transport
0:02:08 > 0:02:11and found himself facing just such a case
0:02:11 > 0:02:14involving one of their bus drivers back in 2007.
0:02:14 > 0:02:18The claimant alleges he was asked by his manager to bring some signs in
0:02:18 > 0:02:19from the car park,
0:02:19 > 0:02:23and, as he's carrying them through to the understairs area,
0:02:23 > 0:02:27he slipped on a plastic, sort of, wallet or folder on the floor
0:02:27 > 0:02:30and he alleged he's fallen backwards and struck his head on the floor
0:02:30 > 0:02:32and knocked himself out.
0:02:32 > 0:02:36SIREN WAILS This was a potentially life-shattering accident.
0:02:36 > 0:02:40He's claiming that he's sustained some quite serious injuries.
0:02:40 > 0:02:44He's alleging that he's prone to blackouts and dizzy spells now.
0:02:44 > 0:02:47He's claiming he's got no memory of the incident, and so he's got
0:02:47 > 0:02:51post-traumatic amnesia for some hours after the incident.
0:02:51 > 0:02:55Bearing in mind this chap could potentially black out at any time,
0:02:55 > 0:02:58he's a bus driver, so this does have some quite serious ramifications for
0:02:58 > 0:03:00his future employment.
0:03:00 > 0:03:02With such severe injuries,
0:03:02 > 0:03:05the claimant's days ferrying passengers from A to B
0:03:05 > 0:03:08had come to a grinding halt... WHEELS SCREECH
0:03:08 > 0:03:11..as well as his ability to make a living.
0:03:11 > 0:03:14First Group were head-on for a colossal pay-out.
0:03:15 > 0:03:17By the time we got to the stage
0:03:17 > 0:03:18where he was ready to put his claim forward in
0:03:18 > 0:03:23its entirety, we'd moved up to round about £650,000.
0:03:23 > 0:03:27A large element of that was for loss of earnings.
0:03:27 > 0:03:30Obviously, he's a bus driver, so, with the potential blackouts,
0:03:30 > 0:03:32he's not going to be driving a bus any more.
0:03:32 > 0:03:36Also, he's got a potential care element -
0:03:36 > 0:03:39over £250,000 he was claiming for that.
0:03:39 > 0:03:41So, it's not an insubstantial claim.
0:03:41 > 0:03:44And, on top of that, you've always got the ever-present legal fees -
0:03:44 > 0:03:47around about £150,000 for those.
0:03:47 > 0:03:51With a whopping £650,000 on the line,
0:03:51 > 0:03:55Lee had to be sure that the details of the claim submitted were genuine,
0:03:55 > 0:04:00and that First Group were in fact liable for the claimant's injuries,
0:04:00 > 0:04:03but there were a few issues authenticating the facts.
0:04:03 > 0:04:07Initial investigations in this case were complicated by the fact that
0:04:07 > 0:04:11the premises where the incident had happened were demolished.
0:04:14 > 0:04:17We can't go back a look at the scene and check the mechanics
0:04:17 > 0:04:19of the incident itself.
0:04:19 > 0:04:21But this didn't stop Lee examining
0:04:21 > 0:04:26what information was available to him in forensic detail.
0:04:26 > 0:04:30He analysed the claimant's original hospital report,
0:04:30 > 0:04:33which turned up some rather head-scratching evidence.
0:04:33 > 0:04:35He's gone to A&E shortly after,
0:04:35 > 0:04:39and they have found no blemishes, no lumps,
0:04:39 > 0:04:41no marks, no bruising...
0:04:41 > 0:04:43Now, for a head injury of this magnitude,
0:04:43 > 0:04:46to knock someone out and cause them a loss of memory
0:04:46 > 0:04:49for a number of hours, you would have thought that there would have
0:04:49 > 0:04:52been some sort of bruise, but they found nothing.
0:04:52 > 0:04:54His Glasgow Coma Scale,
0:04:54 > 0:04:58which is the reading of how someone's conscious state reads,
0:04:58 > 0:05:01he was 15 out of 15, which is fully awake.
0:05:01 > 0:05:03A 3 rating would be dead or in a coma,
0:05:03 > 0:05:07so you would expect him to be somewhere in between.
0:05:07 > 0:05:10So, the medical evidence would suggest the claimant was
0:05:10 > 0:05:12firing on all cylinders.
0:05:12 > 0:05:16But it was his treatments that really gave cause for concern,
0:05:16 > 0:05:19or rather, the lack of it.
0:05:19 > 0:05:22He refused to take a lot of the medication.
0:05:22 > 0:05:24He was very difficult to pin down for appointments.
0:05:24 > 0:05:27Not the action of someone who wants to get better,
0:05:27 > 0:05:30but rather someone who's trying to hide the fact that
0:05:30 > 0:05:32maybe there there's nothing wrong with him.
0:05:32 > 0:05:35First Group had serious concerns that the claimant
0:05:35 > 0:05:37wasn't as impaired as he was professing.
0:05:37 > 0:05:40Lee needed proof to back up his suspicions.
0:05:41 > 0:05:43Following the number of irregularities,
0:05:43 > 0:05:45and the claimant's strange behaviour,
0:05:45 > 0:05:48we decided to seek authority to undergo a series of
0:05:48 > 0:05:51surveillance so that we could actually film the claimant
0:05:51 > 0:05:52and see what he was up to.
0:05:52 > 0:05:55Well, if you're prone to random blackouts,
0:05:55 > 0:05:56need around-the-clock care,
0:05:56 > 0:05:59and are battling bouts of post-traumatic memory loss,
0:05:59 > 0:06:02you might imagine very little, wouldn't you?
0:06:05 > 0:06:09Looking at the footage, it's showing the claimant being allowed to walk
0:06:09 > 0:06:13around quite freely on the family business, which is a small carwash.
0:06:13 > 0:06:18It's quite clear that the impairments he's alleging...
0:06:18 > 0:06:20He's doing all of the things he said he couldn't do.
0:06:20 > 0:06:23You can see him driving cars.
0:06:23 > 0:06:28If he's driving cars around a busy carwash, anything could happen.
0:06:28 > 0:06:32He could drive into pedestrians, into his fellow employees...
0:06:32 > 0:06:36Well, at least he's got his family around to keep a close eye on him.
0:06:36 > 0:06:40He's allowed to cross the road on his own with no real concerns that
0:06:40 > 0:06:42he could black out at any moment.
0:06:42 > 0:06:44Or maybe not.
0:06:44 > 0:06:49He visits the bank on a couple of occasions for 20 and 25 minutes,
0:06:49 > 0:06:52assumingly to carry out some financial transactions.
0:06:52 > 0:06:55The surveillance footage suggested the claimant was living
0:06:55 > 0:06:58what appeared to be a very normal and surprisingly active life,
0:06:58 > 0:07:04and his next task would leave his £650,000 claim all washed up.
0:07:04 > 0:07:07He's seen to be cleaning some of the dirty elements of the car,
0:07:07 > 0:07:10the wheel trims and the lower side of the car.
0:07:10 > 0:07:13He's also seen to be giving supervisory advice.
0:07:13 > 0:07:16He's managing people, to a respect, as well.
0:07:16 > 0:07:19And to cap it off, a spot of DIY.
0:07:19 > 0:07:23Later on in the day, he can actually be seen moving a rather large piece
0:07:23 > 0:07:27of fencing, or a gate, quite near to the carwash.
0:07:27 > 0:07:28And, yeah, this is...
0:07:28 > 0:07:31I think it's with his son, that's helping him do it.
0:07:31 > 0:07:33So, you wouldn't really trust your dad to be moving that
0:07:33 > 0:07:35if he was as ill as he says he is.
0:07:38 > 0:07:40When I first saw the surveillance footage, I thought,
0:07:40 > 0:07:46"This doesn't look like the actions of a person who is
0:07:46 > 0:07:49"needing chaperoning on a 24-hour basis."
0:07:49 > 0:07:52This is someone who can black out at any time.
0:07:52 > 0:07:54With the claimant looking compos mentis,
0:07:54 > 0:07:58his case for compensation was about to take a real blow.
0:07:59 > 0:08:01With all of the inconsistencies that we had in this claim,
0:08:01 > 0:08:03we just weren't happy paying anything out,
0:08:03 > 0:08:07so we went back to the claimant and told him we had concerns,
0:08:07 > 0:08:09and that we weren't going to pay him any money,
0:08:09 > 0:08:12leaving him with very little option to either drop his claim
0:08:12 > 0:08:15or take us to court, and he chose to go down the court route.
0:08:17 > 0:08:20Despite being quite agile day to day,
0:08:20 > 0:08:21when the case got to court,
0:08:21 > 0:08:24the claimant didn't have a leg to stand on.
0:08:24 > 0:08:26When the judge reviewed the surveillance footage,
0:08:26 > 0:08:30he'd said that he would have expected to see someone drive
0:08:30 > 0:08:33this gentleman to the family business,
0:08:33 > 0:08:36escort him from the car under supervision,
0:08:36 > 0:08:39take him to maybe an office and leave him in there,
0:08:39 > 0:08:42seated, without expecting him to be wandering around,
0:08:42 > 0:08:44carrying out aspects of work.
0:08:44 > 0:08:48Once the claimant was shown to be more limber than laid up,
0:08:48 > 0:08:49his case collapsed.
0:08:49 > 0:08:52The outcome of the case was that the judge simply didn't believe
0:08:52 > 0:08:56the level of impairment that the claimant was alleging
0:08:56 > 0:08:59matched the surveillance footage that we had.
0:08:59 > 0:09:02He felt that parts of the claim had been put in with an intention
0:09:02 > 0:09:05to try and deceive us, and therefore,
0:09:05 > 0:09:09because part of the claim was found to be predominantly not true,
0:09:09 > 0:09:11he wouldn't allow any of the claim through,
0:09:11 > 0:09:14so the whole thing was struck out as an abuse of the process.
0:09:14 > 0:09:17It was a just result for Lee and the First Group claims team
0:09:17 > 0:09:21and proof that any suspicious cases will be investigated.
0:09:21 > 0:09:24First will fight these claims to trial.
0:09:24 > 0:09:29We do often take these sorts of cases on and we will normally win.
0:09:34 > 0:09:36Still to come,
0:09:36 > 0:09:40a first-class postal fraud is detected by Royal Mail...
0:09:40 > 0:09:46Checks revealed that Mr Mohammed had set up three online auction accounts
0:09:46 > 0:09:48in the space of three minutes.
0:09:53 > 0:09:55Going on holiday, whether you're a sun-worshipper,
0:09:55 > 0:09:57a culture vulture or thrill-seeker,
0:09:57 > 0:10:00is most people's chance to get away from the stresses and strains
0:10:00 > 0:10:02of everyday life.
0:10:02 > 0:10:05Holiday insurance is something you hope you will never have to use,
0:10:05 > 0:10:09but if your great escape turns into a bout of tourism trauma,
0:10:09 > 0:10:13then having the right level of cover in place can be a life-saver.
0:10:14 > 0:10:17Simon Cook is head of special investigations
0:10:17 > 0:10:19for holiday insurers Cega.
0:10:19 > 0:10:23His team received one particular call from a distressed holiday-maker
0:10:23 > 0:10:24in a desperate situation.
0:10:26 > 0:10:30The customer contacted our medical emergency helpline to explain that
0:10:30 > 0:10:32he had fallen whilst trekking in Morocco.
0:10:34 > 0:10:36With such a serious accident,
0:10:36 > 0:10:40Simon's team didn't waste any time getting to grips with the claim.
0:10:40 > 0:10:41As part of our service,
0:10:41 > 0:10:44we contacted the hospital to obtain a medical report,
0:10:44 > 0:10:48so we could see the injuries the customer had sustained.
0:10:48 > 0:10:50It sounds like it was a serious fall,
0:10:50 > 0:10:53because the customer had sustained a fractured vertebra,
0:10:53 > 0:10:54ankle and wrist.
0:10:54 > 0:10:58The value of the claim was just over £50,000.
0:10:58 > 0:11:01The claims handler passed the medical report over to
0:11:01 > 0:11:04Cega's specialist team, as is standard practice,
0:11:04 > 0:11:08which revealed a rather major discrepancy.
0:11:08 > 0:11:11What rang alarm bells for us was that the medical report,
0:11:11 > 0:11:14which did, in fact, contain limited information,
0:11:14 > 0:11:17stated that the customer had been involved in a paragliding accident,
0:11:17 > 0:11:21which was completely different to what he initially told us happened.
0:11:21 > 0:11:23In case your French is a little rusty,
0:11:23 > 0:11:27this translates as "victim of a paragliding fall",
0:11:27 > 0:11:32i.e gracefully riding pockets of air at heights of up to 18,000 feet.
0:11:32 > 0:11:36Just a tad different to a mosey through the Moroccan hills,
0:11:36 > 0:11:37as he originally reported.
0:11:37 > 0:11:41We asked the customer to clarify why the circumstances were different on
0:11:41 > 0:11:45the medical report to what he actually had told us when he first
0:11:45 > 0:11:47contacted us.
0:11:47 > 0:11:50A claims handler from Simon's team gave the claimant a call
0:11:50 > 0:11:51to clarify the details.
0:12:36 > 0:12:40So, the claimant was now adamant he had not paraglided,
0:12:40 > 0:12:43but that wasn't the only thing that didn't add up.
0:12:43 > 0:12:47Cega's experts had been taking a closer look at the medical report.
0:12:47 > 0:12:50For the customer to have sustained these type of injuries,
0:12:50 > 0:12:53he would have had to have fallen from a significant height.
0:12:54 > 0:12:56A significant height.
0:13:05 > 0:13:06A couple of metres?
0:13:06 > 0:13:09The claimant's injuries were more consistent with a fall
0:13:09 > 0:13:11from a much greater height -
0:13:11 > 0:13:15I don't know, maybe those sustained from a paragliding accident.
0:13:15 > 0:13:18With his story starting to feel like a flight of fancy,
0:13:18 > 0:13:21the team dug a little deeper.
0:13:21 > 0:13:22On the back of the initial call,
0:13:22 > 0:13:25we did some background searches on the internet
0:13:25 > 0:13:29and found some videos that heavily affiliated the customer
0:13:29 > 0:13:32with paragliding and paramotoring.
0:13:32 > 0:13:34This information was put to the claimant.
0:14:00 > 0:14:03MUSIC: Eine Kleine Nachtmusik by Wolfgang Amadeus Mozart
0:14:10 > 0:14:12It's about now that the claimant should be reaching
0:14:12 > 0:14:17for his parachute, as his story is set to crash and burn.
0:14:17 > 0:14:21He has now admitted to paragliding in the past, albeit a long time ago,
0:14:21 > 0:14:24but is claiming not to be active any more.
0:14:24 > 0:14:27Let's see what other grains of truth the claims handler can extract
0:14:27 > 0:14:29on this call.
0:14:29 > 0:14:32Determined to ground the claimant's version of events for good
0:14:32 > 0:14:34and get to the bottom of this case,
0:14:34 > 0:14:37the investigation turned towards the scene of the accident
0:14:37 > 0:14:39in search of new evidence.
0:14:39 > 0:14:43As we knew the precise location where the incident occurred,
0:14:43 > 0:14:45we managed to obtain the telephone number
0:14:45 > 0:14:47for a local paragliding company.
0:14:47 > 0:14:51The person that we spoke with at the paragliding company confirmed
0:14:51 > 0:14:54that, at the same day and at the same time, he had in fact
0:14:54 > 0:14:58attended to someone who had had a paragliding accident.
0:15:24 > 0:15:25On the balance of probability,
0:15:25 > 0:15:28the fact that the incident had occurred at the same time,
0:15:28 > 0:15:31the same day and the same location,
0:15:31 > 0:15:34it would certainly suggest that this could well be our customer.
0:15:35 > 0:15:38Between the discrepancy in the initial medical report,
0:15:38 > 0:15:40the nature of the claimant's injuries,
0:15:40 > 0:15:42his affiliation to paragliding,
0:15:42 > 0:15:45and the eyewitness account from the scene of the accident,
0:15:45 > 0:15:49his version of events really started to nosedive.
0:15:49 > 0:15:52As the call went on and we disclosed the evidence we had,
0:15:52 > 0:15:55the customer then started to tell us that he couldn't remember
0:15:55 > 0:15:58what happened, which we thought was extremely odd.
0:16:15 > 0:16:20The claimant has developed a sudden and very convenient case of amnesia,
0:16:20 > 0:16:22but playing dumb wouldn't help his cause.
0:16:22 > 0:16:27Due to the fact that the customer was still denying that the incident
0:16:27 > 0:16:29was as a result of paragliding,
0:16:29 > 0:16:31we explained to him that we were going to have to
0:16:31 > 0:16:33complete on-the-ground inquiries in Morocco,
0:16:33 > 0:16:36and we required him to sign an authority form for us.
0:17:05 > 0:17:10It may have taken a while, but the truth had at last landed.
0:17:10 > 0:17:13We firmly believe that the customer knew that he didn't have the right
0:17:13 > 0:17:17level of insurance cover, and that's why he provided us false information
0:17:17 > 0:17:19from the outset of the claim.
0:17:19 > 0:17:22We had no option but to decline the claim in full
0:17:22 > 0:17:24and there was no appeal from the customer.
0:17:26 > 0:17:29Having an accident abroad and finding yourself uncovered
0:17:29 > 0:17:31is stressful enough,
0:17:31 > 0:17:34but, by lying about the circumstances of his accident,
0:17:34 > 0:17:38the claimant could have added an attempted fraud prosecution
0:17:38 > 0:17:39to his problems.
0:17:39 > 0:17:42We certainly appreciate the situation the customer
0:17:42 > 0:17:46found himself in, because the claim value was over 50,000,
0:17:46 > 0:17:50but this doesn't mean that you can provide false information to obtain
0:17:50 > 0:17:51insurance cover.
0:17:51 > 0:17:53Holidays can be expensive,
0:17:53 > 0:17:57and extreme sports can bump up a travel insurance premium,
0:17:57 > 0:17:59but trying to save a few quid here or there
0:17:59 > 0:18:01could cost you thousands later
0:18:01 > 0:18:05should something go wrong and you're not appropriately covered.
0:18:05 > 0:18:07We're still unsure why such an experienced paraglider
0:18:07 > 0:18:11wouldn't have taken out the right level of cover prior to travelling.
0:18:13 > 0:18:17You do need to have the right level of insurance cover when you travel,
0:18:17 > 0:18:20especially when you're going to take part in extreme sports
0:18:20 > 0:18:22such as paragliding.
0:18:27 > 0:18:31The Royal Mail has been collecting, carrying and delivering all packages
0:18:31 > 0:18:34great and small for over 500 years,
0:18:34 > 0:18:37so, if something fails to arrive at its intended destination,
0:18:37 > 0:18:39it's a big deal.
0:18:39 > 0:18:42Customers are always compensated for any genuine losses
0:18:42 > 0:18:43or damaged items.
0:18:43 > 0:18:46It's a fact that insurance cheats have cottoned on to
0:18:46 > 0:18:48and are exploiting -
0:18:48 > 0:18:51commonly submitting false claims for lost or unreceived items.
0:18:54 > 0:18:57Diane Matthews is a fraud manager for Royal Mail,
0:18:57 > 0:18:59and it's her job to identify and investigate
0:18:59 > 0:19:02any suspected fraudulent claims.
0:19:02 > 0:19:04She was passed one case which involved their
0:19:04 > 0:19:06premium delivery service.
0:19:07 > 0:19:09Royal Mail customer services received a complaint from
0:19:09 > 0:19:13a customer that a special-delivery item was delivered
0:19:13 > 0:19:15without the contents.
0:19:15 > 0:19:19There's nothing more frustrating than receiving an empty package,
0:19:19 > 0:19:22and it's a matter Royal Mail takes very seriously.
0:19:22 > 0:19:25The contents of the special-delivery item were said to be
0:19:25 > 0:19:29a gift card of £260, so, obviously, quite valuable,
0:19:29 > 0:19:32and a loss to Royal Mail of quite a significant amount.
0:19:32 > 0:19:36These cases are always investigated, and it's standard practice
0:19:36 > 0:19:39to look into the claims history of the customer.
0:19:39 > 0:19:41Checks were made as to the recipient,
0:19:41 > 0:19:45and it was found that they'd made three similar claims
0:19:45 > 0:19:47in the space of six weeks.
0:19:47 > 0:19:49Mr Mohammed, the claimant,
0:19:49 > 0:19:52was actually stating that there was gift cards inside
0:19:52 > 0:19:56each and every one of them envelopes, and, on each occasion,
0:19:56 > 0:19:58the envelope was delivered to him empty.
0:19:58 > 0:20:02The chances of that are, I would say, slim to none.
0:20:03 > 0:20:06With the gift cards mysteriously disappearing,
0:20:06 > 0:20:09but the actual packages being successfully delivered,
0:20:09 > 0:20:14it was one of Royal Mail's employees who first came under scrutiny.
0:20:14 > 0:20:17The finger of suspicion fell on the postman
0:20:17 > 0:20:19that was due to deliver that item,
0:20:19 > 0:20:22and, when we went further into the case
0:20:22 > 0:20:25and found out this was one of several claims, obviously,
0:20:25 > 0:20:31our impression changed and we then started looking at Mr Mohammed.
0:20:31 > 0:20:34And they didn't have to look far to see an alarming pattern.
0:20:34 > 0:20:37It was found that, over the 14-month period,
0:20:37 > 0:20:40he'd made numerous claims for loss,
0:20:40 > 0:20:44mainly small electronic items and mobile phones,
0:20:44 > 0:20:48latterly going on to the gift cards that he'd bought.
0:20:48 > 0:20:50To further this investigation,
0:20:50 > 0:20:53I started to look a bit more closely at the gift cards.
0:20:53 > 0:20:56With such a high number of claims over a short period,
0:20:56 > 0:21:00the spotlight of suspicion was now fixed on Mohammed.
0:21:00 > 0:21:02Diane and her team turned their attention to
0:21:02 > 0:21:05Mohammed's online activities.
0:21:05 > 0:21:10Checks revealed that Mr Mohammed had set up three different
0:21:10 > 0:21:15online auction site accounts in the space of three minutes,
0:21:15 > 0:21:20and on each one, it was used to facilitate a purchase.
0:21:20 > 0:21:25On each occasion, he told the seller that they had not been delivered.
0:21:25 > 0:21:28Royal Mail had sussed out Mohammed's MO.
0:21:28 > 0:21:32The evidence suggested he was buying discounted gift cards online under
0:21:32 > 0:21:36different guises, and claiming to both the vendor and Royal Mail
0:21:36 > 0:21:38that his purchases had never been received.
0:21:38 > 0:21:43The seller was contacted and they forwarded details of the card,
0:21:43 > 0:21:46which allowed us to go to the various stores
0:21:46 > 0:21:48and find out the transactions,
0:21:48 > 0:21:53and also to ascertain if any CCTV evidence of them transactions
0:21:53 > 0:21:55was still available.
0:21:55 > 0:21:58Each gift card has a unique identity number,
0:21:58 > 0:22:02making them easily trackable when purchases are made.
0:22:02 > 0:22:03With this information,
0:22:03 > 0:22:06Diana was able to zero in on specific store locations where
0:22:06 > 0:22:10the supposedly-lost gift cards had been used,
0:22:10 > 0:22:13and, most importantly, check their CCTV recordings.
0:22:17 > 0:22:20When the CCTV footage was viewed,
0:22:20 > 0:22:24we identified Mr Mohammed as being the person spending
0:22:24 > 0:22:28the £260 gift card on several occasions,
0:22:28 > 0:22:31as well as being used by a family member.
0:22:31 > 0:22:34Mohammed had been caught red-handed on camera.
0:22:34 > 0:22:37It was the crucial evidence Royal Mail needed to prove
0:22:37 > 0:22:38the fraudulent activity.
0:22:38 > 0:22:42He'd also passed the gift card to an unknowing relative,
0:22:42 > 0:22:45who had also been using it in good faith to make purchases,
0:22:45 > 0:22:49therefore implicating an innocent family member in his crime.
0:22:51 > 0:22:55At this point, we had enough evidence to arrest Mr Mohammed,
0:22:55 > 0:22:58so we sought assistance from Greater Manchester Police,
0:22:58 > 0:22:59who assisted us with that.
0:23:00 > 0:23:04Diane and her investigative team had worked hard to crack this case,
0:23:04 > 0:23:08and were determined to be there when justice was delivered.
0:23:08 > 0:23:10Myself and my colleagues from Royal Mail investigators
0:23:10 > 0:23:14accompanied the police on a search of Mr Mohammed's home address.
0:23:14 > 0:23:17Evidence was then seized from his bedroom that matched
0:23:17 > 0:23:22the identical cards that were reported as not being received,
0:23:22 > 0:23:25and at that moment you knew that the right person had been caught.
0:23:28 > 0:23:31Mohammed was given an opportunity to explain why the gift cards
0:23:31 > 0:23:34were found at his property.
0:23:34 > 0:23:37Mr Mohammed was subsequently interviewed by officers of
0:23:37 > 0:23:40Royal Mail and he chose to answer, "No comment,"
0:23:40 > 0:23:42to all of our questions.
0:23:42 > 0:23:44But by the time the case reached court,
0:23:44 > 0:23:46Mohammed had changed his tune.
0:23:46 > 0:23:51Mr Mohammed pled guilty at court to two charges of fraud,
0:23:51 > 0:23:55and he received a six-month community service order
0:23:55 > 0:23:57and also a curfew.
0:23:57 > 0:24:01No matter how big or how small attempts to defraud Royal Mail are,
0:24:01 > 0:24:03they will always be met with the same response.
0:24:03 > 0:24:07The actual value of this claim is irrelevant to Royal Mail.
0:24:07 > 0:24:10The modus operandi of this is fraud and therefore it needs to be
0:24:10 > 0:24:12investigated and stopped.
0:24:18 > 0:24:19Now, in recent years,
0:24:19 > 0:24:24the UK has acquired the catchy title of the whiplash capital of Europe,
0:24:24 > 0:24:28with an estimated 2.7 claims made for every reported accident.
0:24:28 > 0:24:31Now, while many of those claims are genuine,
0:24:31 > 0:24:34the injury has long been seen by potential fraudsters
0:24:34 > 0:24:37as an easy, low-risk way to make a few quid.
0:24:37 > 0:24:39Whether it's otherwise honest individuals making
0:24:39 > 0:24:42a one-off exaggerated claim from a real accident
0:24:42 > 0:24:46or organised gangs masterminding calculated
0:24:46 > 0:24:49"crash for cash" cons, it is all fraud.
0:24:49 > 0:24:53Axa's head of fraud Richard Davies is no stranger
0:24:53 > 0:24:55to these types of claims.
0:24:55 > 0:24:58His team received one particular case from an Axa customer
0:24:58 > 0:25:02which involved multiple third-party passengers.
0:25:02 > 0:25:06Our customer told us that they'd collided with another vehicle -
0:25:06 > 0:25:11as a result, five whiplash claims were submitted to us.
0:25:11 > 0:25:14They were meant to involve three male passengers -
0:25:14 > 0:25:18one of 60, one of 40 and one of roughly 20 -
0:25:18 > 0:25:22- and two younger Caucasian females. - BRAKES SCREECH AND CAR SMASHES
0:25:22 > 0:25:26So, three boys and two girls in the car during the accident -
0:25:26 > 0:25:28seems pretty clear.
0:25:28 > 0:25:32There was a really big problem with this claim.
0:25:32 > 0:25:37Our customer had told us there were three males and two females
0:25:37 > 0:25:38in the car.
0:25:38 > 0:25:41However, when the claims came in,
0:25:41 > 0:25:45there were two males and three females in the car.
0:25:45 > 0:25:49That's fundamentally inconsistent and meant that we had to doubt
0:25:49 > 0:25:52whether or not the claims were genuine.
0:25:52 > 0:25:55Aside from one of the passengers mysteriously morphing into a woman,
0:25:55 > 0:25:58there's also the matter of the two female occupants who were reportedly
0:25:58 > 0:26:04Caucasian, but now seem to be hailing from an Asian background.
0:26:04 > 0:26:08It was a discrepancy that brought the case to an emergency stop.
0:26:08 > 0:26:10We rejected all of these claims,
0:26:10 > 0:26:15which were at that point valued at around £23,000.
0:26:15 > 0:26:18The claimants, however, refused to accept that
0:26:18 > 0:26:20and decided to take us to court,
0:26:20 > 0:26:25and we estimated that it would cost around about £200,000
0:26:25 > 0:26:28to defend those claims.
0:26:28 > 0:26:32That's over ten times the amount of the original claim.
0:26:32 > 0:26:35Confident that this was a classic case of an opportunistic attempt
0:26:35 > 0:26:39at fraud, Axa weren't prepared to back down.
0:26:39 > 0:26:41The claimants came across very badly in court.
0:26:41 > 0:26:45When they were cross-examined, they changed their story,
0:26:45 > 0:26:47they changed the circumstance of the accident
0:26:47 > 0:26:51and the judge held that they just weren't credible witnesses.
0:26:51 > 0:26:54So far, it may have looked like a game of "Guess Who?",
0:26:54 > 0:26:57but there was no mistaking the identity of the claimants when
0:26:57 > 0:26:59the final judgment was passed.
0:26:59 > 0:27:02The judge threw all five claims out of court.
0:27:02 > 0:27:07He said that the people weren't in the car and he made an order
0:27:07 > 0:27:10against them to pay Axa's legal costs.
0:27:10 > 0:27:13These individuals clearly thought, win or lose,
0:27:13 > 0:27:16there would be no consequences to submitting a false claim,
0:27:16 > 0:27:19but they were gravely mistaken.
0:27:19 > 0:27:22We think that the claimants were motivated just by money.
0:27:22 > 0:27:26They thought that they could get away with £23,000 from an insurance
0:27:26 > 0:27:31company simply by submitting five fake claims.
0:27:31 > 0:27:33When we know that a claim is false,
0:27:33 > 0:27:37we will defend it and we will take those claimants through the court
0:27:37 > 0:27:41system to make sure they are shown to be criminal.
0:27:41 > 0:27:45And it's the honest policyholders who ultimately pay the price.
0:27:45 > 0:27:49It cost us £200,000 to defend them.
0:27:49 > 0:27:52Those costs are paid on to genuine customers
0:27:52 > 0:27:56and is the reason why £50 is added to each premium that we pay
0:27:56 > 0:27:57for each policy we own.
0:28:03 > 0:28:06Insurance fraud hits all of us in the pocket,
0:28:06 > 0:28:08but more and more of these scammers and conmen
0:28:08 > 0:28:11are being claimed and shamed.