Episode 1 Claimed and Shamed

Insurance fraud has reached epidemic levels in the UK.

It's costing us more than £1.3 billion every year.

That's almost 3.6 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 around £50 to your insurance bill.

But insurers are fighting back, exposing just under 15 fake claims

every hour. Armed with covert surveillance systems...

Subject out of 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, undercover filming causes a £250,000

personal injury claim to fall down.

This is quite surprising footage, really.

It is, I suppose, shock value.

A bus claim stalls when CCTV reveals there was no accident.

We did wonder whether or not we'd pulled the right footage,

considering what she was claiming for. So we checked our disks

and, yes, it was the right one.

And a woman is caught planning her husband's murder by an

undercover police officer posing as a hit man.

Like a lot of people, I used to think

that insurance fraud only occurs when someone

completely fabricates a claim for something that never happened.

A flatscreen TV supposedly stolen in a break-in, for example.

It's a common misconception.

The penalties for exaggerating a claim that is otherwise

genuine are just as severe.

Building work poses all sorts of dangers

and, despite the hard hats and high-vis tabards,

accidents will happen.

Any responsible employer will have insurance cover to protect

their staff should the worst happen.

As in this case.

Mr Kittle was working for our policy holder

at a private property.

Rob Smith-Wright is the claims manager for insurers QBE.

He was in the process of ascending a ladder...

..when the ladder gave way underneath him.

As he fell, the ladder trapped his knee and actually he suffered

a fracture to both his tibia and fibula.

In other words, a double leg break.

So the injuries that Gary Kittle

would have suffered would have been quite debilitating.

He would have required open surgery,

he would have required a significant period of rehabilitation

before he could have been considered fit to work again.

As part of the claims process, he was examined by

a medical expert, who provided more detail about his condition.

He was severely restricted in what he was able to do,

he wasn't able to climb ladders.

He was claiming he was finding difficulty in walking up and

down stairs, being able to crawl,

undertake general household duties, so we were being painted

a picture of someone who was in a really serious state.

Since Mr Kittle's injuries were so significant,

the cost of the claim was rapidly expanding.

We would have been looking at compensation

in the region of £25,000.

As it stood, there was nothing unusual about the claim.

We had no reason to doubt the incident.

We had no reason to doubt the injury that he had suffered.

But what they did have reason to doubt was the extended length

of his recovery.

Our first suspicions arose around March 2009.

Mr Kittle had been released from rehabilitation treatment

and we had been advised in those medical records that he'd had

a full range of pain-free movement

and therefore he could return to work.

However, Mr Kittle alleged that his symptoms were continuing

and he didn't feel that he was able to return to work.

This was outside of the general range of the recovery period

expected for this kind of injury.

The upshot being that he required further compensation,

since he was still allegedly unable to earn a living.

Our next steps, really, were to discover whether or not

Mr Kittle was indeed as injured as he says he was.

With that in mind,

investigators carried out surveillance on the claimant.

The surveillance footage we would have expected to have seen

with regards to Mr Kittle would have been someone who wasn't as

mobile as he possibly could have been,

who was suffering

in pain and movement,

and generally would have been

unable to undertake even, you know,

the simplest of household duties.

But the filming shows

a different picture.

Kittle isn't exactly

keeping a low profile -

his bright-red jumper

sort of stands out.

The first footage that we obtained

showed the claimant working,

despite the fact that

we had been told that he had been signed off from work.

He was seen digging and he was seen

moving a wheelbarrow,

directly contradicting the general

capabilities that he says he can do.

So the initial reaction to

the first period of surveillance

was one of surprise.

To eliminate the possibility

that Kittle was just having

a good day, further surveillance

was carried out.

It showed Mr Kittle in a rather more precarious position,

which was up on a roof.

For a man who allegedly

had mobility issues,

stairs would have been a problem,

let alone a ladder.

He was working for a roofing company.

He could be seen both ascending

and descending ladders with ease.

He could be seen

moving quite large...

lifting heavy objects.

Generally, this was a picture of

someone who was far more

capable of work and far more capable of activities than

he was actually letting us know.

At this point, we were convinced

that Mr Kittle was grossly

exaggerating the symptoms

that he was suffering.

The surveillance continued and produced even more damning evidence.

What it actually showed was a further recovery period

for Mr Kittle.

Here we see him getting into what appears to be a work van

and driving off.

When he arrives at his destination,

it's apparent that he's not there on a social visit.

He's there to work -

carrying a bucket,

sweeping the patio,

moving a bench,

and even operating a backpack sprayer.

I mean, whatever he's doing here just takes the biscuit.

The footage shows that he'd dug himself into a bit of a hole.

This is quite surprising footage, really,

simply because of the level of restriction that Mr Kittle

was telling us that he had, so it is, I suppose, shock value.

By now, the level of evidence against Mr Kittle was overwhelming.

It was at this point that the case then began to unravel for Mr Kittle.

We then disclosed all the surveillance evidence that

we had gathered to the claimant's solicitors,

and we simply asked them the question,

"Was this Mr Kittle in the footage?"

They confirmed it was, and it was at that point, then,

that we decided that we would not be making any kind of offers.

He'd been caught out,

but, instead of walking away,

Mr Kittle tried to put QBE on the back foot, with a demand for costs.

The schedule that he served thereafter was in excess

of £250,000, and that wasn't including the injury

that he had suffered, as well -

this would have been special damages such as lost earnings,

future care and things like that.

-PHONE RINGS

-Our initial response to that wasn't

one of major surprise,

simply because we had already established that Mr Kittle

was exaggerating his symptoms.

So, it wasn't too much of a stretch for him to exaggerate

the cost of the claim.

Unfortunately for Mr Kittle, QBE weren't going to accept it.

At that point, we made a conscious decision that Mr Kittle's deceit

extended into criminal activity,

and we decided that we would take the route of a private prosecution.

It's an unusual step. It's not generally done.

However, the penalties are far more severe using a private prosecution.

The surveillance footage was central to their case.

It painted the picture of a man that was prepared to

lie to medical experts,

with regards to his conditions and what his true capabilities were.

We sent the surveillance footage to our medical expert,

and we asked him to comment upon that against the medical report

that he'd previously disclosed to us.

I think it was fair to say that his response to that was,

erm, quite damning.

As was the final verdict in the private prosecution.

He was summoned to attend Guildford Crown Court in May 2015,

and he pleaded guilty to two of the three charges

that were laid against him.

Mr Kittle was sentenced to an immediate custodial sentence of

12 months' imprisonment.

Mr Kittle now has ample time on his hands to reflect on

where he went wrong.

So, Mr Kittle, as far as we were concerned,

had suffered a genuine incident,

and had suffered a genuine injury.

Had he been true and honest,

and played the claim with a straight bat, there was every chance

that Mr Kittle would have walked away with some kind of compensation.

However, greed took over.

It's a simple fact that insurance fraud is a crime.

Exaggeration is insurance fraud and if you do commit it,

and we have the evidence against you,

we will pursue the claims to the fullest extent the law allows us to.

Later, a serial fraudster is locked up...

Why should people get away with

making fraudulent claims?

It's theft at the end of the day.

It's stealing.

..and a stark warning to would-be bus accident blaggers.

There is no getting away with it.

If we catch you, and we will,

we will pursue you through the criminal and the civil courts.

Now, if you or I were involved in an accident where the other driver

was at fault, we'd expect to be compensated.

Once the vehicle had been repaired and any injuries treated,

that would be the end of it.

But hold that thought -

unfortunately, not everyone thinks like that.

There is a certain minority who try to exploit the system.

They attempt to take advantage of genuine accidents to

get a bigger pay-out than they're entitled to.

But when they get caught out,

they end up much worse off than when they started.

WHEEL CRUNCHES

Susan Evans is the fraud manager for Admiral.

The initial claim that we received,

our policyholder had pulled out of a side road in wet conditions,

into the path of a third-party vehicle.

It was a genuine accident.

There was nothing wrong with the circumstances at all.

So, the claim was promptly processed.

The claim was for the damage to the vehicle -

it was £6,100,

and Admiral paid the value in full, in a cheque.

On the face of it,

it was a run-of-the-mill motor insurance claim,

just like the 3 million others processed every year in the UK.

Usually, at this point in a claim, everybody goes away happy,

and we wouldn't normally hear from anybody else again.

Yup, job done, case closed...

or so Susan thought.

On this particular occasion, having issued the cheque,

we get a phone call to say that the cheque had been misplaced.

Can't find it, and could we possibly issue another one?

We like to wait a few days, just to check that the Post Office

hasn't delivered to the wrong address, for example.

With that in mind,

Admiral got back in touch with the claimant to see if it had arrived.

Following on from this,

Admiral received a number of calls about the cheque.

They were very, very persistent.

I think there were around seven calls in total,

telling us that the cheque hadn't arrived.

They were primarily from the partner of the claimant.

And they were very, very convincing,

telling us that this cheque has been misplaced.

But the call handler needed to be sure,

and decided to double-check the third-party's version of events.

Admiral have procedures that we follow to check if a cheque

has been banked, and it turned out that it had.

It was banked somewhere quite close to where the third party lived.

The call handler immediately spoke to the company

to confirm what had happened.

So, we were immediately wondering,

has somebody picked the cheque up in error?

Has somebody else banked the cheque?

We didn't immediately think that a fraud had been committed.

But something obviously wasn't right -

someone was now £6,100 better off.

There was, though, one way to establish who had cashed the cheque

with the company.

Photographic ID had been provided by the gentleman,

as is required when they bank a cheque,

and it was the third party.

There's no way that you're going to forget doing that

so it was quite obvious that there had been an attempt to mislead us.

This is something that is taken very seriously

and the third party had to face the consequences of their actions.

We decided to speak to the police.

The police actually took the case from us

and they received a caution as a result of that.

All the third party had to do was pay in the cheque

and collect the money they were rightfully owed,

but they've now ended up on the wrong side of the law.

It wasn't that clever a fraud, I have to say, and it was quite easy

for us to prove that a fraud had been committed.

Unfortunately for the third party,

they've now got a chequered financial record.

There is nothing more annoying than losing your phone

while you're out and about.

We've all been there, and you wouldn't be alone -

more than 20,000 mobiles are misplaced on the capital's

public transport system every year.

It is, in fact, the number one item of lost property.

With top-of-the-range of handsets costing more than £500,

fraudsters have begun to target phone insurance,

but the industry is fighting back.

Andy Morris is the president and CEO of Assurant Solutions Europe.

So, this is an incredible case.

It started with one of our highly-skilled agents effectively

being concerned that some of the data didn't correlate.

The agent noticed a strange pattern emerging across

a large number of claims.

One of the anomalies that they found was that the location of the loss

of the phones was actually always on the London Underground.

It was enough for Assurant to take a closer look,

and to identify how many claims were suspicious.

Well, as it quickly escalated into over 60 cases,

and a cost to the industry

and to us of over £30,000.

It became clear that this was a significant, organised,

fraudulent activity.

At this point, Assurant liaised with the British Transport Police,

who have authority over the UK's rail networks,

including the London Underground.

DC Darren Griffiths took on the investigation.

He went through the phone recordings made when the losses were reported,

and the similarities were striking.

It was the same story, the same script he was going by every time,

and basically what he'd say,

his phone would have been lost - it would have been lost on a train.

He'd give the reference number,

and then he'd ask for a handset replacement.

By sifting through the evidence,

Darren was able to figure out how the scam worked.

The phones were real.

The claims, in a sense,

are not real because he never actually lost the phone.

He's got a phone, and he's basically obtaining a second phone

on the strength of saying, "I've lost one,"

so he'll get a replacement or a cash reimbursement.

The replacement phones were then sold on the black market

for a tidy profit,

and any reimbursements were banked.

However, he'd made one basic error, for which he'd pay the price.

The voice was very similar all the time,

so they believed it was the same person.

And all the losses occurred a suspiciously short time after

the insurance was taken out.

At this point,

it seemed a large-scale fraud was being attempted,

so they followed the money trail.

The bank account always has to come back to somebody

and that way we really sort of narrowed it down.

To one person - a man called Lateef Irawo.

Mr Irawo came up as owning those bank accounts,

where he had contact with or control of with those bank accounts.

But the sheer number of claims he'd made using his details -

name, address and bank account - meant the scam hit a snag.

Mr Irawo was, sort of, running out of options.

The insurance company was getting wise to him and refusing

a lot of the claims he was making.

That silence was deafening.

As if submitting fake claims wasn't bad enough,

he decided to up the ante by branching into identity theft.

This was his blatant attempt to cover his tracks when

he took out the insurance contracts.

He was using different identities, pretending to be someone else.

There would be different addresses,

but the pattern would start coming in again,

cos he'd have to change it somewhere along the line for him to benefit,

for him to get the gain.

And to get the replacement phone, it has to be sent to an address

where he can pick it up from.

This meant he had to change the false address he'd given

when taking out the contract.

Like most fraudsters,

Irawo tried to maximise the income from the identities he'd stolen.

Experience has shown us that they don't just open one contract.

They'll go down the high streets,

they'll open a contract in all the providers,

get as many phones as they can with that ID.

So, it's not usually one phone to one person -

it could end up with four or five phones against their name.

But this tactic only worked up to a point -

his victims soon became aware that their details had been stolen.

We did checks with Action Fraud

to see if these people had actually reported in

and a majority of them actually had reported losses.

Irawo was being pursued from every direction.

The BTP made its move and raided an address associated with him.

Pieces of suspect paperwork were found.

Several of them turned out to be fraudulent documents,

counterfeit documents,

and this would be either utility bills or identity documents.

The evidence against him was overwhelming,

and Irawo was arrested and finally brought to justice.

Mr Irawo was found...

He pleaded guilty to the conspiracy

and to the possession of articles for use in fraud

and to the money-laundering.

Mr Irawo received three years' imprisonment.

It was a good result, really,

for the courts to hand out a heavy sentence.

Sentenced alongside him were Timothy Edembe Ikome and Ayeni Adekunle,

who both received 21 months inside.

It's not just a one-off.

This was almost a campaign by Mr Irawo to try

and defraud the insurance company.

There's a renewed determination to bring the people behind

these crimes to justice.

This is a career criminal, really.

I mean, he spent three years making his living from fraud,

and why should people get away with making fraudulent claims?

It's theft at the end of the day.

It's stealing.

Later, a social media check pulls the plug on a dodgy claim...

The so-called independent witness was known to the claimant for

at least a year before the trial date.

..and a wife plots to murder her husband in cold blood

for his life insurance.

Now, with phones getting ever smarter,

greater CCTV coverage and the rise of social media,

it's not just TV presenters who are constantly being filmed.

So, it is easy to forget you're on camera 24/7,

which isn't normally a problem,

unless you're a fraudster trying to make a fake insurance claim.

In cases where it's one person's word against another's,

a few seconds of footage can make all the difference.

Julie Randall is the claims team manager for First Group.

She recently dealt with a case involving one of their buses.

This claim arose as a result of our bus clipping the wing mirror

of a third-party vehicle.

It was a very minor accident.

In fact, there was no damage to our bus and there was

no damage to the wing mirror.

Nor was there any damage to the passengers.

No injuries were reported at the time of the accident.

The incident was noted

and, in most cases, that would have been that.

However, the following day,

we had a phone call from the father of one of the passengers.

He alleged that his daughter had been thrown out of her seat

to the floor, she sustained a nasty head injury,

and had to be taken to the hospital.

According to the woman, she'd been seriously hurt.

The claimant alleged that she'd sustained injuries to her neck,

to her upper and lower back, to her shoulders,

she'd sustained soft-tissue damage to her left ankle,

and also pins and needles in her left leg.

She also sustained severe psychological problems,

including nightmares, fear of travel,

she had flashbacks of the accident,

and she was quite distraught over the whole thing.

Well, given the severity of the incident,

the potential cost of the claim was substantial.

With the injuries this lady sustained,

we would have expected to put a value of £12,000.

This would be made up on her damages for both her physical

and her psychological injuries, her treatment fees,

and also her legal costs.

But something about the claim didn't ring true.

Bearing in mind it was only a clipped wing mirror sustained

by our bus, we were extremely surprised and suspicious when

a claim came in for personal injury.

It was only minor damage and the injuries were quite severe.

Julie immediately launched an investigation.

Once we receive the call,

we decided to go back and watch the CCTV footage.

Our buses are fitted with over 17 cameras,

so we obviously had a good view of the upper deck,

and the lower deck, and the outside of the bus.

Considering the list of injuries we had presented to us,

I was expecting to see quite a traumatic event,

watching the footage.

I was expecting to see the claimant thrown from her seat,

hitting her head on the seat in front, thrown to the floor,

rolling around in extreme pain, and screaming her head off.

Julie rewound the footage to a few moments before the impact occurred.

Look away now if you don't want to see a nasty accident.

So, I'm waiting for the collision to happen,

and you can see the car coming along the side of the bus.

I can see the claimant.

She's actually texting away on her phone.

And I'm just waiting for it to happen, and...

..nothing's happened.

Although she has carried on texting on her phone,

and she's not lost her place on the keypad.

Remember, this was an accident for which she was

trying to claim £12,000.

We did wonder whether or not we'd pulled the right footage,

considering what she was claiming for, so we checked our disks

and, yes, it was the right one.

I was quite staggered, the lengths that this lady went to.

We later found out that she had actually gone to hospital

and she had seen a consultant.

That was quite shocking to us.

And she may well have prevented a genuinely injured person

having urgent treatment.

Predictably, the £12,000 wasn't handed over.

This claim was clearly a complete fabrication,

and we provided the CCTV footage and our evidence to her solicitors.

Unsurprisingly, they went away very quickly.

We had no intention of paying this completely fabricated claim.

The claimant evidently underestimated how far

the fraud team would go to get the truth.

I don't think this lady really thought her claim through

when she presented the lies that she did.

She lied to her own medical examiner.

She lied to the A&E consultant.

She lied to her own solicitor.

But the camera never lies,

and that's what exposed the claim as a sham.

There is no getting away with it.

If we catch you, and we will,

we will pursue you through the criminal and the civil courts.

Social media is everywhere these days.

With a few clicks and the odd scroll,

you can see people's updates, photos,

check who's friends with who,

or who's de-friended you.

That's awkward.

So, when fraudsters try to take a swipe at insurance premiums,

they can find themselves caught in a web of their own making.

Mihir Pandya is the fraud manager at Allianz.

He recently dealt with a case involving a road traffic accident.

We were initially presented with five injury claims

from individuals who alleged

that our policy holder's delivery van driver

had crashed into their stationary car while they were inside it.

According to the claimants, they'd suffered significant injuries.

Each of the five personal injury claims that we received were

in the region of £2,500.

Adding up to a cool £12,500.

Clearly, the case warranted further investigation.

It was at this point that the personal injury claims started

to look a little shaky.

Our policy holder's delivery van driver's version of events

differed greatly to that provided to us by the claimants.

According to her,

she was driving down what was a very narrow street and she noticed

at the time that there were two individuals exiting

from a local chemist shop, walking towards the car

and, as she drove past them, that's when she heard a scraping noise.

On looking in the mirror, she saw the same two individuals standing

next to the car with both doors open and the male was flagging her down.

That's when she realised that she may have scraped the car.

The side of the car might have needed some work

but, according to the van driver, at least no-one had been hurt.

She exchanged details with the two individuals and she tells us

that she was there at the scene for at least 25 minutes and,

during that time, she didn't see any passengers emerge from the car,

nor could she see anybody from outside looking in.

So how did a dented panel on an empty car result in

a huge compensation claim for five people?

Well, it didn't.

In our view, the personal injury claims were fictitious.

Sadly, this is nothing new.

The phenomenon even has its own name.

"Phantom passengers."

Phantom passengers are where fictitious passengers

are added to the claim to inflate the total value.

The more people, the more injuries, the more compensation.

But, Allianz saw through this tactic.

We repudiated the claims based on the information we had

in our possession

and subsequently, some months later,

four of the claimants issued proceedings against us.

This took quite some nerve, seeing as none of them had been in

the car at the time and at least two had never even been at the scene.

At this point, another figure appeared from out of nowhere.

About three months before the trial dates, the claimant's side

produced what they said was an independent witness.

Not only had the van driver not been aware of a witness,

but the timing was somewhat suspicious.

Normally we would expect, if there was an independent witness,

for this to be presented at the start.

Because we thought this was a little unusual,

we undertook some checks, one of which was looking at social media.

This identified that, in fact, the so-called independent witness

was known to the claimant for at least a year before the trial date.

Their social media profiles had forced a shutdown.

And as a result, the independent witness could

not be described as independent.

Meaning that their credibility was fatally flawed.

During the trial, the judge agreed with our view

and so refused to have her evidence submitted.

As the trial progressed,

the claimants watched their chances dwindle away.

The judge wasn't very impressed with the quality of the evidence

provided by the claimants either and, in his view, there were

no passengers in the car, so threw the entire claim out.

And there was a further ruling which left our phantom passengers

wishing they really could disappear.

He also ordered them to pay our legal costs.

The fact that they've also ended up with

a considerable bill for legal costs means that they are

effectively worse off than when they started.

Any problems we have with insurance fraud in the UK pale

in comparison to the scams that are pulled in the States.

US fraudsters will stop at nothing to get their hands on a pay-out,

even if it means committing the ultimate evil.

Meet Julia Merfeld.

The young mother of two is seen here meeting

a contact for the first time.

From the clip, Julia appears relaxed and cheerful,

as she tries to juggle her schedule.

The topic then moves on to money.

A lot of money.

Now, if you're thinking

there's something strange about this scenario,

not least the fact that it's all been recorded

on a hidden camera, then you'd be right. This is no innocent chat.

Julia Merfeld is speaking to a hit man and she's arranging for him

to murder her husband, the father of her children, in cold blood.

But there's a twist.

The hit man is actually an undercover police officer.

Which was worth a huge 400,000.

With the camera rolling, the officer has to get Merfeld to admit

as much as possible, which means going into specifics.

In order to win Merfeld's trust,

the officer needs to put on the performance of his life.

Evidently, Merfeld has already put a lot of thought into the hit.

The only time Merfeld shows any concern is when she

speculates that a burglary-gone-wrong scenario

might be off-putting for a potential housemate.

She is also keen that the murder doesn't happen inside the property.

To guarantee she gets the life insurance pay-out,

Merfeld is keen to put on a good show.

While the evidence on camera is strong, the officer needs to

make sure there can be no doubt about Merfeld's intent.

He rounds things up and arranges to meet again.

The next day, the officer waits.

Whether Merfeld returns is a test of how convincing he's been.

But she's here, and she's come prepared.

But she's yet to hand over the money,

something that could prove to be a vital piece of evidence.

She appears to be justifying her actions

as a twisted act of kindness to spare him going through a divorce.

From the officer's point of view,

it's vital that there's no ambiguity.

He needs to push her into specifics.

For the first time, she looks troubled.

The officer steers the conversation towards money.

If she hands over the down payment, he's got proof of her intent.

At this point, he makes it clear there's no backing down.

The officer gives her a final warning.

If she's going to call it off, it has to be now.

But there are no second thoughts and no mercy.

Shortly afterwards, she was arrested

and eventually pleaded guilty to solicitation to murder.

Amazingly, her husband stood by her,

saying, "She had been nothing but a great mother to our two children."

However, the judge thought otherwise

and sentenced her to more than five years and eight months behind bars.

Nobody likes paying more than we have to for everyday services.

From organised criminal gangs to exaggerated household claims,

insurance fraud hits all of us in the pocket.

But, instead of getting away with it,

more and more of these fraudsters are being claimed and shamed.