Episode 2 Claimed and Shamed


Episode 2

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Transcript


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Insurance fraud has reached epidemic levels in the UK.

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

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That is almost £3.6 million every day.

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Deliberate crashes, bogus personal injuries, even phantom pets.

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The fraudsters are risking more and more to make a quick killing,

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and every year it's adding around £50 to your insurance bill.

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But insurers are fighting back,

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exposing just under 15 fake claims every hour.

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Armed with covert surveillance systems...

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The subject out of the vehicle.

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..sophisticated data analysis techniques...

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

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Police! Stay where you are!

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..they are catching the criminals red-handed.

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Just don't lie to us.

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All those conmen, scammers and cheats on the fiddle

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are now caught in the act and claimed and shamed.

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Today, the Met Police Traffic Unit hunt for a crash-for-cash suspect...

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One particular person that I'm looking for.

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If he's identified, then I will go and arrest him.

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I've a warrant...

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..a claimant's story falls apart...

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..and a trip-and-slip claim is grounded by CCTV.

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When we first saw the footage, you can't help but chuckle

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at its ridiculous attempts to invent a claim.

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Now, as we all know,

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when we get behind the wheel, driving does have its dangers.

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But one of the greatest risks on our roads are crash-for-cash gangs.

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They're ruthless, they're convincing and they don't care who gets hurt.

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Here's how it works.

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First, the gang choose a victim, then they move their two cars

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into position in front of the target.

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Gang car number one then slams on its brakes.

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Gang car two reacts by breaking hard,

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resulting in a rear-end shunt from the victim.

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Gang car one then turns off at the nearest possible exit,

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pretending to be unaware of the crash,

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leaving the victim supposedly at fault for the damage

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to gang car two.

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The gang then exaggerates the amount of damage and injury

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in order to get more compensation.

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It's so well practised that you might not even realise

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you've been a victim, but the police are fighting back.

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The Met's Roads & Transport Policing Unit

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has built its reputation on smashing organised criminal gangs

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operating crash-for-cash rings.

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In this next case they were approached by a large retailer.

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The company was concerned about a series of incidents

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involving their delivery vans.

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DI Dave Hindmarsh heads up the proactive team

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for the Traffic Command.

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This fraud first came to light

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by one of the well-known supermarkets...

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came to ourselves, the Met Police.

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They believed they had a problem

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with one of their distribution centres

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and the fact it has a disproportionate amount of collisions,

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which they now believed to be suspicious.

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But it soon became clear this was no ordinary crash-for-cash operation.

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Something strange was afoot.

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The suspicious collisions and claims were varied.

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There was the usual induced collision that we see quite a lot,

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with a vehicle running into the back of another.

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But there were also some other collisions

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which were vehicles reversing round corners into parked cars,

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which we hadn't seen before.

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So it was quite unusual to have two different sets of circumstances.

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Either way, a considerable amount of money was at stake.

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In terms of the claims that were coming in,

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they were for personal injury, whiplash,

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pre-accident value for the vehicle,

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credit hire for a replacement vehicle

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whilst the other one was being repaired or had been written off.

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They were averaging around about £20,000-£30,000 per claim.

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But as yet they didn't know how many bogus collisions

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they were dealing with or how to connect the main suspects.

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We were investigating this for some time

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and we were a bit confused because some of the links

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weren't there where we would expect them to be,

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and then there was a slight eureka moment by the officer involved

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in the case when we actually identified there were two gangs

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who had actually targeted the supermarket chain

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independent of each other,

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which was why we couldn't find links with every single person involved.

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We'd never come across two different gangs who weren't working

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with each other, didn't know about each other

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targeting the same victim.

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It was quite unusual from our point of view.

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This unprecedented coincidence explained the two different types

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of circumstances.

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The team then looked into the individuals associated

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with each group.

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One of the organised gangs,

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we identified the ringleader as Bashir Zairi.

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Zairi was an interesting character.

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In fact, he had used various derivatives of his name

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to become involved in what appeared to be about 100 collisions

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and, all told, he'd made about £279,000 out of those collisions.

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A breathtaking amount of money.

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The next step for DI Hindmarsh's team was to raid addresses

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they suspected were connected to Zairi

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and the raft of sham claims.

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We couldn't initially pin what address he resided at,

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so we decided we would execute some search warrants at two addresses

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in north London. Those addresses had been used significantly

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in a number of the collision claims, so it was a good place to start.

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The magistrates gave us two search warrants

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and we executed those both on the same day.

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So, early on the morning of 27th March, 2013,

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a squad of officers from the Met Police's Traffic Enforcement Department

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executed the two warrants.

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Dave's colleague, DC Anthony Recchia gives a briefing before the raid.

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We're going to divide into two teams,

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hit the two addresses, which are opposite each other.

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There's one particular person that I'm looking for.

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Bashir Zairi.

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If he's identified and he's there, then I will go and arrest him.

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Briefing over, the officers travel to the raid locations.

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Any operation comes with risks.

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They have no idea what they're going to find

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or who might be lying in wait.

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Still to come...

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I've got a warrant to search your address.

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..the Traffic Unit officers make a crucial discovery...

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In a nutshell, these two addresses

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are involved in about 100 fraudulent road traffic claims.

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..and a personal injury claimant's story doesn't stand up.

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We see a huge range of cases,

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and CCTV can sometimes be a little bit 50/50,

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but this was absolutely 100% compelling and damning.

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Photography is a pastime that's now easier than ever

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with smartphones and apps.

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But take a look at this.

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Did you know that muggins here contains a wealth of information,

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or metadata?

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For example, the date and time you took it

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to the location, down to the street name.

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It instantly puts fraud investigators in the picture

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and can be used to shoot down false claims.

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Simon Cook is the Head of Special Investigations at Cega,

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a company that deals with all sorts of travel insurance claims,

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from medical emergencies to mislaid gadgets.

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A customer contacted us to make a claim for a lost watch,

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which he unfortunately lost while swimming on holiday in France.

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The woman then went into detail about the circumstances of the loss.

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The customer told us that the incident happened on a Sunday.

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She also said that this was a triathlon watch,

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but she specifically made reference to not competing in a triathlon

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at the time of losing the watch.

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We thought that was extremely strange

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cos we hadn't even asked a question about that.

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Hey, there might have been a reason

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why she wanted to set the record straight.

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This is significant because the customer's policy

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doesn't provide cover if she was taking part in a race.

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To a fraud expert like Simon, it suggested that there was more

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going on than met the eye.

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As part of the standard claims procedure,

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we ask the customer to provide us

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with some form of proof-of-ownership documentation.

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We thought she probably should have had something to support the watch,

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as the actual item would be still within a 12-month warranty period.

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Not an unreasonable assumption for a top-of-the-range watch.

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The customer had a think about it and stated initially

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that she didn't have anything at all

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to support the ownership of the watch.

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However, it wasn't long before they heard from her again.

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In the meantime, things seem to have changed.

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After a short period of time,

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the customer sent us a completed claim form

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and she also sent us a photograph which actually showed the box,

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the guarantee and all other documents that related to the watch.

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This was the last thing Simon and the team were expecting.

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We thought that was particularly strange

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because the customer had made a specific point during the first call

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saying that she'd thrown away the box

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and all the other documents relating to its purchase.

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Although it seemed suspicious,

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it WAS possible that it could have been an old photo taken

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before the items were thrown away.

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There was only one way to find out.

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As part of our review, we check the properties, or metadata,

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of the photograph and noted that the photograph had in fact been taken

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after the incident date

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and it had been taken at a different address

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to the customer's home address.

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Now, either the customer had access to a time machine

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or her story was seriously off track.

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This is when the claim was referred to our Special Investigations Unit.

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They wasted no time looking into what the customer was doing

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on what day during her French break.

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We decided to conduct some internet research,

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which quickly found the customer's name as listed as competing

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in a race in France at the time she claimed she'd lost the watch,

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and therefore the watch must have been lost at the time

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she was in the triathlon.

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This completely contradicted what the customer had told Cega.

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The fact the customer specifically told us she wasn't taking part

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in a triathlon tends to support that she knew

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she wouldn't be covered for this incident.

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No cover meant she wouldn't have been entitled to a pay-out.

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It looked as though the claim had run its course,

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but Cega needed to be sure.

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Based on the level of evidence we had obtained,

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we decided we were going to need to speak with the customer

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by way of telephone interview.

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They started by asking the claimant what should have been

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an easy question - the date of the loss.

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At this point, the customer had in fact given a different date

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to the date that she originally provided to us

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during the initial call.

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We challenged the customer on this particular point,

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regarding the date,

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and the call went particularly quiet.

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It was a straightforward question

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and yet the claimant struggled to give a straight answer.

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For fraud experts like Simon and his team,

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umming, ahing and pausing

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are classic signs of someone trying to buy time.

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If a story is genuine,

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then there's no reason for a claimant to be hesitant.

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Things had started badly

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and unfortunately for our claimant here,

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they only got worse when she was asked about the photograph.

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After further deliberation,

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she stated her husband's friend

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had probably taken the photograph of his own watch

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to give to her in order to support her claim.

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It was now clear that the watch claim's days were numbered.

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The customer clearly misrepresented the facts about her participating

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in the triathlon.

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In addition to this,

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she had provided us with false information regarding the photograph

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she had sent us.

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And she had nothing to say for herself when she was confronted

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with her dishonesty.

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She'd admitted that she had been less than honest

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and this cast doubt on her entire story.

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This could have had very serious consequences.

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Cega had no choice but to call time on the watch claim.

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We declined the claim and invoked the relevant fraud condition on the policy

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and we didn't ever hear from the customer again.

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To be perfectly honest, I would have been amazed if we had heard from her.

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Most of us wouldn't dream of getting behind the wheel

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without insurance,

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but lots of people think differently.

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It's estimated that there are

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one million uninsured vehicles in the UK.

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And hit-and-run accidents are on the rise.

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If you've been the victim of a hit-and-run driver,

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well, you're not on your own.

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You can apply for compensation to the Motor Insurers' Bureau, or MIB.

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Such applications are subject to a set of strict guidelines.

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The MIB's Head of Technical is Paul Ryman-Tubb.

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One of the rules within the agreement

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relating to hit-and-run accidents is that the claim has to be made to MIB

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within three years.

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The majority of victims make a claim soon after an accident occurs.

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But there are some exceptions.

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We received first notification of this claim, February 2013.

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The claim form described an accident in August 2010.

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It had happened two and a half years before,

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meaning it was still within the three-year limit.

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So, within the claim form,

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Simon Rule said that he was crossing the road

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when he was hit by a vehicle that then left the scene of the accident,

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leaving him with some very serious injuries.

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With the claimant being so badly hurt,

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the potential cost of compensation was considerable.

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The claim could have been worth several hundred thousand pounds,

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possibly up to £1 million.

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According to the claimant, in the period since the accident,

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his condition hadn't improved.

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Two and a half years later, he was saying that he was still suffering

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significantly from the injuries.

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He was still facing surgery

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and still needed considerable care and assistance.

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Since the claim had been made within the three-year time limit,

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everything appeared to be in order.

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We had no reason to doubt the claim at all at this stage.

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We receive lots of claims involving hit-and-run drivers

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and this was just another claim that we received.

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If, on an investigation, we had been satisfied that it was caused

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by the hit-and-run driver,

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then we would have been paying compensation to Mr Rule.

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But that's a big if. An investigation was duly launched.

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One of the first things that we do on almost every case

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is apply for a copy of the police report.

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That gives us really important information,

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normally taken at the time or thereabouts, of the accident

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and independently verifying exactly what's happened.

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The response was cause for major concern.

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The information that we received from the police

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was alarmingly different to what we were being told.

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What it was describing was an incident where Mr Rule's car

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started to roll down a hill

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because he hadn't set the handbrake correctly and,

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in an attempt to stop it rolling away,

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he was injured by his own vehicle.

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He had effectively run himself over.

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And there was no mention of another driver or a hit-and-run.

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What's more, the incident happened much earlier than claimed.

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Exactly a year before the accident that was reported to us.

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Meaning it had happened three and a half years previously,

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and was therefore outside the time limit.

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So he had lied about the date, he had lied about the circumstances,

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and he had lied about running himself over.

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Something tells me nothing about this claim was true.

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We wrote to the claimant's solicitors,

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explaining firstly that it was out of time, and secondly,

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that the circumstances were very different to those claimed

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on the claim form,

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and in fact it would appear that the incident was entirely Mr Rule's fault.

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The claim was rejected and, predictably,

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they heard nothing more from the solicitors.

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But the MIB weren't prepared to park the case.

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They passed the details to the police.

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We were then contacted by an officer investigating the potential fraud,

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who told us that, on initial discussions with Mr Rule,

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he denied making a claim to MIB at all.

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But there could be no doubt that Mr Rule had attempted to make a claim.

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We were quite surprised to hear that he was denying making a claim.

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He had signed a claim form and sent it into us via his solicitors.

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To make absolutely sure, the form was sent to forensics.

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They had carried out some analysis of the claim form,

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found Mr Rule's fingerprints on it

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and so they were continuing with their prosecution.

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He was brought to justice and ended up with a suspended sentence

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of two years and ordered to pay a fine of £600 and court costs.

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And there was a further irony.

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It later transpired that Mr Rule's vehicle

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should never have been on the road in the first place,

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because it was in fact uninsured.

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We, in fact, have received claims

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from the owners of some of the parked vehicles that it hit

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as it rolled down the road.

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For Paul Ryman-Tubb, the biggest concern

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is the knock-on effect of fraud.

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MIB and insurers have to put time and resource and effort

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into investigating fraudulent claims.

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All of that resource could, of course,

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be better spent compensating genuine victims.

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Still to come...

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Fraudsters can no longer walk away from false claims.

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Where we do get an award for damages,

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we will look to go after a fraudster's assets,

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his home, his car, even an attachment to earnings

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for those that actually do work.

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And a woman pays a high price for her greed.

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This is a case where we have a lady

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who is of a reasonable standing in the community.

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She now has a tarnished record.

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Earlier, the Met's Roads & Policing Unit were investigating

0:21:350:21:39

a suspected crash-for-cash fraudster called Bashir Zairi.

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They are now ready to move in and put a stop to his scam.

0:21:430:21:46

Two addresses. One of the premises is a semidetached house.

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It's just a car park on the left here.

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And the other premises is one of these flats in here.

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It's 7am when they arrive,

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and both of the addresses are hit simultaneously.

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Good morning.

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Police.

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Morning, police. Let us in?

0:22:070:22:09

We've got a warrant to search your address.

0:22:090:22:11

Go upstairs. Go.

0:22:110:22:13

At both locations, the inhabitants cooperate

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and allow the officers entry.

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We'll just have a quick look, and if I'm happy that it's safe,

0:22:170:22:21

we will let you get up and get dressed on your own, is that OK?

0:22:210:22:23

Unfortunately, there's no sign of the main suspect.

0:22:230:22:26

The person we're looking for is not present.

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But other people are.

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There is correspondence which relates to that person

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that we're looking for the premises,

0:22:330:22:35

so we are just going to start our search now.

0:22:350:22:37

With Zairi not present,

0:22:370:22:38

the success of the raid rests

0:22:380:22:40

on whether the team can find documentary evidence

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to strengthen the case against him.

0:22:430:22:45

Hello? All right.

0:22:450:22:47

Police officer. Anyone else in this room with you?

0:22:470:22:50

We are looking for any documentation relating to the claims.

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That could be physical documentation, bits of paper,

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it may well be e-mails or documents that have been stored digitally,

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so that could well be on laptops or computers.

0:23:010:23:04

So far, the search has turned up

0:23:040:23:06

lots of potential pieces of evidence.

0:23:060:23:09

20 minutes into the raid, DI Hindmarsh

0:23:090:23:11

has made an important discovery.

0:23:110:23:14

We've identified another address,

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which officers are just on their way to now,

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to find hopefully our subject.

0:23:180:23:19

If all goes well,

0:23:190:23:21

they will soon have their main suspect

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and several sacks of evidence.

0:23:230:23:26

We've seized all the media equipment, laptops, computers,

0:23:260:23:30

mobile telephones, because that will assist us.

0:23:300:23:33

In a nutshell, these two addresses are involved in about 100 fraudulent

0:23:330:23:38

-road traffic claims.

-With the search over, the officers return to base.

0:23:380:23:42

The evidence collected on the raid

0:23:430:23:45

meant that they could prove the connection

0:23:450:23:47

between the properties and Zairi,

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even when he was using a slightly different identity.

0:23:490:23:52

Because they were derivatives of his name,

0:23:520:23:55

it could have been open to him to say that that was not him.

0:23:550:23:57

But the paper documents,

0:23:580:24:00

they proved the link with Mr Zairi to those addresses.

0:24:000:24:05

It was exactly what the team had set out to find.

0:24:050:24:08

In terms of the two raids, they were very successful.

0:24:080:24:13

The fact that we managed to recover some significant evidence.

0:24:130:24:16

And there was also a result for the officers trailing Zairi.

0:24:160:24:19

We were able to find another address in North London

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that a couple of our uniformed colleagues who were present with us,

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who left for that address and were able to arrest and detain Bashir

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that morning. So it was a good bit of work.

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But this was just the start.

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It takes years, unfortunately,

0:24:350:24:37

from the inception of a case and the conclusion at the court.

0:24:370:24:42

In the months and years that followed the raid,

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Dave and his team worked steadily to build a case against Zairi.

0:24:440:24:47

It transpired that he had attempted

0:24:480:24:50

to gain a considerable amount of money.

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He had claimed about £313,000

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but actually only got around £279,000 himself.

0:24:580:25:03

Zairi eventually appeared at court

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and all the hard work that had been put into the investigation paid off.

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He pleaded guilty. He realised that the evidence against him

0:25:090:25:14

was overwhelming.

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Taking into account how much money he'd tried to claim,

0:25:150:25:18

the judge came down hard.

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Mr Zairi was sentenced to three years' imprisonment.

0:25:220:25:25

A significant custodial period

0:25:260:25:28

and something that is becoming more common.

0:25:280:25:31

The courts have become more alive

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to induced commissions and the sentencing has started to go up.

0:25:330:25:38

This is down to the realisation that crash for cash

0:25:380:25:41

-isn't just about the money.

-There is also the human cost.

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People are going out there, causing crashes.

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They do not know what the outcome is going to be.

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Someone could be seriously injured or, in fact, killed.

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With Zairi behind bars,

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the force is in the process of recovering the money

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that was paid out.

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There could have been serious consequences

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if the supermarket hadn't realised something was wrong.

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Had they not noticed the issue and come to the Met Police,

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then that would have continued,

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and who knows where it would have led to?

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Now, like most people, I am guilty of having a good old moan

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about health and safety. But at the end of the day,

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it's there to protect us.

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And if we are injured because our employers

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haven't provided a safe working environment, then it's right

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that we are entitled to compensation.

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But it's wrong when this is exploited by fraudsters.

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Scott Clayton is Zurich's claims fraud and investigations manager

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and he recently dealt with a workplace injury case.

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The claim that we received from Ms Quansah-Okoe

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was in respect of personal injury.

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She claimed that she fell within the canteen of Lambeth College

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on what she says was a wet floor.

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According to her, this was no mere stumble.

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The injury was quite serious that she was telling us she suffered.

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It was soft tissue injuries, damage to her wrist, leg, ankle and,

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believe it or not, she actually said that she had chipped a tooth.

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The claimant alleged she had required

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a considerable amount of treatment.

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Ms Quansah-Okoe suggested that she had been to hospital

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straight after the accident.

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She was off work for two or three weeks,

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and she had six bouts of physiotherapy treatment.

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All this added up to a tidy sum.

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We estimated the claim to be worth in the region of £8,000.

0:27:380:27:42

So quite a considerable sum of money.

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But then again, she was saying that she was considerably injured.

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With so much money on the line,

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the claimant was asked to provide more detail

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about how the accident had actually happened.

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She mentioned that the floor was wet,

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and she only noticed that the floor was wet

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when she actually felt the wetness on her dress.

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So she was saying that the college canteen floor was wet

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and that caused her to slip and be injured.

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According to her version of events,

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the college had been negligent and was therefore liable.

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On the surface, this looked like a claim that, certainly,

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we would consider paying, because of the nature of the injuries,

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and what caused them.

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What made this case different was that Lambeth College,

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when they submitted the claim, also enclosed some CCTV footage.

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The footage changed everything.

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Once the insurance company had looked at the CCTV

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and looked at what Ms Quansah-Okoe was claiming,

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they had obvious concerns,

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so they passed the claim on to IFED for investigation.

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IFED is the City of London Police's

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insurance fraud enforcement department,

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headed up by DCI Oli Little.

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He reviewed the footage.

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I think, given the injuries that she is claiming for,

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we would expect to see someone at least lose their footing

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really suddenly and fall down.

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One of those ones where you look at it and you go, "Ooh!

0:28:580:29:01

"That must have hurt." But there is nothing like that here.

0:29:010:29:04

And judging by the injuries, she has given herself quite a battering.

0:29:040:29:07

So the fact that she said she chipped a tooth,

0:29:070:29:09

she must have slammed her face on the floor.

0:29:090:29:12

That sort of footage isn't normally that pleasant to watch.

0:29:120:29:15

What we did see was something entirely different.

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So different that it completely turned the case on its head.

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She walks into the canteen fairly briskly.

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Then she notices that the chap's mopping the floor.

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So what she's probably done, in my opinion,

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is that during that period of time when she slows down,

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she's thought herself,

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"Here's an opportunity for me to invent an incident

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"and claim compensation."

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And that's where the idea's come into her head.

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And, as you can see, she approaches that post.

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The bags come down really carefully, down to the knees,

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and then there's that sort of final flourish at the end.

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That's nothing like what you would expect to see

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if somebody's got injuries head to toe, broken teeth,

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it's just complete invention.

0:30:030:30:05

The footage completely undermined the case and her credibility.

0:30:050:30:09

When we first saw the footage,

0:30:090:30:11

you can't help but chuckle at its ridiculous attempts

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to invent a claim.

0:30:150:30:17

But there was a serious side to the situation, too.

0:30:170:30:20

The CCTV was absolutely crucial

0:30:200:30:22

because it told us exactly what happened

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and, in effect, demonstrated that it was a fraudulent claim.

0:30:240:30:27

As far as Zurich was concerned,

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her chance of a pay-out was now absolutely zero.

0:30:290:30:33

So, we shared the footage with her solicitors

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and the claim was discontinued.

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But the consequences didn't end there.

0:30:400:30:42

If Ms Quansah-Okoe thought she could just walk away from the claim,

0:30:420:30:46

she was wrong.

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Such was the ridiculous nature of this claim

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and the evidence that we had,

0:30:500:30:52

we felt this was definitely a good case to refer to IFED.

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IFED agreed, and decided to pay the claimant a little visit.

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When we arrested Ms Quansah-Okoe, I think she was quite shocked.

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Maybe she thought, like a lot of people do,

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"What's the worst that can happen if I put this claim in?

0:31:050:31:08

"They will just say no." She didn't expect to get arrested.

0:31:080:31:11

She didn't expect to get interviewed by the police.

0:31:110:31:14

But that's exactly what happened.

0:31:140:31:16

Ms Quansah-Okoe was eventually charged

0:31:160:31:19

with fraud by false representation.

0:31:190:31:21

You would have thought that she may have decided that the game was up,

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but, no, undeterred, she proceeded right through a criminal trial.

0:31:260:31:29

The case was heard at the Old Bailey.

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She pled not guilty, despite the overwhelming evidence against her.

0:31:320:31:37

With her star turn caught on CCTV, the outcome was never in doubt.

0:31:370:31:42

And a jury found her guilty and she was sentenced

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to 80 hours' community service

0:31:450:31:47

and ordered to pay £500 towards the cost of running the case.

0:31:470:31:50

Perhaps she'll spend that doing some mopping.

0:31:500:31:53

Or perhaps working on her acting skills.

0:31:530:31:55

We see a huge range of cases,

0:31:560:31:58

and CCTV can sometimes be a little bit 50/50,

0:31:580:32:01

but this was absolutely 100% compelling and damning.

0:32:010:32:06

Insurers like Zurich are determined

0:32:060:32:08

to put a stop to the compensation culture.

0:32:080:32:10

For us, it was the conviction that mattered,

0:32:100:32:13

because it sends a message that people who try and invent these type

0:32:130:32:17

of incidents to claim compensation should be warned that,

0:32:170:32:20

if you're caught,

0:32:200:32:21

then you end up feeling the full force of the law.

0:32:210:32:23

Now, in normal circumstances,

0:32:280:32:30

fraudsters wanting to submit fake accident claims

0:32:300:32:33

have to shell out for actual motor policies.

0:32:330:32:36

These upfront costs can be a deterrent in themselves,

0:32:360:32:39

so free cover is particularly appealing to scammers.

0:32:390:32:43

This is especially true of drive-away policies.

0:32:430:32:46

These policies allow scammers to claim pay-outs for accidents

0:32:490:32:52

that never happened involving cars they never owned.

0:32:520:32:55

Sarah Hill is the head of fraud at lawyers BLM.

0:32:570:33:00

You could take out seven days' free comprehensive motor insurance cover,

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which would allow you to, for instance,

0:33:060:33:08

if you are purchasing a new vehicle, obtain that vehicle, be covered,

0:33:080:33:12

insured on it to drive it away.

0:33:120:33:14

And that was on the basis that you would then go on

0:33:140:33:17

-to look for a full quote.

-In other words,

0:33:170:33:20

the seven-day policies function as a type of marketing tool,

0:33:200:33:23

not unlike a free sample.

0:33:230:33:25

Tom Gardiner is the head of fraud at Aviva,

0:33:270:33:29

one of the insurers providing this type of product.

0:33:290:33:32

When the data surrounding some of these seven-day policies

0:33:330:33:36

was analysed, his team noticed an alarming trend.

0:33:360:33:39

The initial thing that alerted us to this case was our claim centre

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noticed that the same person was reporting multiple claims.

0:33:440:33:49

We then quickly went on to link other claims

0:33:490:33:52

to the same telephone number,

0:33:520:33:54

e-mail address and credit card.

0:33:540:33:56

It turned out a whole network of people was involved.

0:33:560:33:59

Suspicions were also raised because the accidents all happened

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within the brief, seven-day timeframe.

0:34:030:34:05

Obviously very unlikely that the same person

0:34:050:34:08

would have so many accidents

0:34:080:34:10

in such a short space of time.

0:34:100:34:12

Either they were incredibly unlucky, or there was something more sinister

0:34:120:34:16

going on. When they took a closer look at the accidents,

0:34:160:34:19

they made a startling discovery.

0:34:190:34:22

This was all just a paper exercise.

0:34:220:34:24

No accidents had taken place.

0:34:240:34:27

They were all fabricated.

0:34:270:34:28

This is how it worked -

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claims would be submitted

0:34:300:34:31

where a car insured on a seven-day policy was

0:34:310:34:34

said to have gone into the back of another.

0:34:340:34:36

The driver of the other car would then claim compensation

0:34:360:34:40

for personal injury on the free seven-day policy.

0:34:400:34:43

And the bill for the fraudulent claim was footed by the insurers.

0:34:430:34:47

Not only were the accidents fake,

0:34:470:34:50

the gang had never owned the cars involved.

0:34:500:34:53

They would be identifying genuine vehicles.

0:34:530:34:57

They just didn't belong to them.

0:34:570:34:58

Instead, they sourced registration numbers

0:34:590:35:02

from car auction websites and lied to the insurers,

0:35:020:35:05

saying they owned they cars when they didn't.

0:35:050:35:07

The free policies meant there was no initial financial outlay,

0:35:090:35:12

so there was nothing to stop them making more claims,

0:35:120:35:15

mostly for whiplash.

0:35:150:35:17

73 claims in total for injury and damage

0:35:170:35:20

were presented to the insurance company.

0:35:200:35:23

What would have been paid out if these claims had been genuine

0:35:230:35:26

was in the region of £500,000.

0:35:260:35:28

They had tried to cover their tracks

0:35:280:35:31

by using stolen identities and credit cards,

0:35:310:35:33

but inevitably, there were loose ends.

0:35:330:35:36

They were all purporting to be different individuals,

0:35:360:35:38

yet you would have the same credit card

0:35:380:35:40

being used to set those policies,

0:35:400:35:42

which is very unusual.

0:35:420:35:43

Interestingly, the same e-mail address

0:35:430:35:46

between the non-fault parties and the fault parties.

0:35:460:35:50

We even had, on one accident,

0:35:500:35:52

the same address being used across two different policies,

0:35:520:35:56

so there was lots of things to link all of the accidents together.

0:35:560:36:00

Since the fraudsters didn't own the cars

0:36:000:36:02

and the accidents never happened,

0:36:020:36:03

Tom's team were able to identify and stop the suspect claims.

0:36:030:36:08

Despite the fact that we had avoided all the claims,

0:36:080:36:10

we were not content to let it rest there.

0:36:100:36:13

Aviva worked closely with lawyers BLM

0:36:130:36:15

to come up with a strategy to bring the fraudsters to justice.

0:36:150:36:19

We were advised that we had strong evidence on a number of cases

0:36:190:36:22

and we decided to bring a civil action against 15 of the claimants.

0:36:220:36:26

What we looked to do was to recover the costs that the insurance company

0:36:260:36:31

had incurred in investigating these claims

0:36:310:36:34

and also defending these claims,

0:36:340:36:36

because they were entitled to recover back

0:36:360:36:39

what they had lost as a result of this scam.

0:36:390:36:41

A civil action was then brought against the 15 claimants.

0:36:410:36:45

A lot of them didn't take legal representation.

0:36:450:36:49

They effectively buried their heads in the sand.

0:36:490:36:51

I think they were hoping this would just go away.

0:36:510:36:53

They were certainly not expecting such a proactive strategy

0:36:530:36:56

by the insurance company.

0:36:560:36:58

A proportion admitted their guilt.

0:36:580:37:00

But some persevered, and the case went to trial.

0:37:000:37:03

None of them had put in a defence to the claim,

0:37:030:37:06

so it was simply a matter of the judge assessing

0:37:060:37:09

what damages the insurance company should be awarded.

0:37:090:37:12

Nine times out of ten, that would have been the end of it.

0:37:120:37:15

But not in this case.

0:37:150:37:17

It was quite interesting, actually, the trial,

0:37:170:37:19

because it wasn't without its drama.

0:37:190:37:23

One of the individuals that we brought a claim against

0:37:230:37:26

turned up with his wife and tried to protest his innocence.

0:37:260:37:30

The judge actually told him that he found the evidence overwhelming

0:37:300:37:34

in this case, in terms of the fraud.

0:37:340:37:36

Unsurprisingly, the result didn't exactly go their way.

0:37:360:37:40

We were pleased with the outcome of the hearing.

0:37:400:37:42

We got judgments against 15 people

0:37:420:37:45

and we were awarded costs and damages

0:37:450:37:48

of over £90,000.

0:37:480:37:50

The fraudsters were hit where it hurts the most -

0:37:500:37:53

in the pocket.

0:37:530:37:54

And where we do get an award for damages, we will look to go

0:37:540:37:58

after a fraudster's assets, his home, his car,

0:37:580:38:02

even an attachment to earnings for those that actually do work.

0:38:020:38:05

It's quite frequently our experience that the fraudsters are

0:38:050:38:08

full-time criminals and don't actually hold down a full-time job.

0:38:080:38:12

It's a stark warning to fraudsters

0:38:120:38:13

who think they might be able to get away with a similar scam.

0:38:130:38:17

In this case, not being content with avoiding the claims,

0:38:170:38:20

we have gone on in taking further action against the claimants,

0:38:200:38:24

which we hope will act as a deterrent in the future.

0:38:240:38:26

Moving house is one of the most stressful things you can do.

0:38:310:38:34

But imagine how much worse it is if your possessions get damaged.

0:38:340:38:39

When this happened to one unlucky woman,

0:38:390:38:41

she got in touch with her insurer to make a claim.

0:38:410:38:43

Mike Brown is Direct Line Group's head of counter-fraud intelligence.

0:38:490:38:54

The policy owner in this case was moving home and, in transit,

0:38:540:38:59

she reported the fridge freezer and some perishables were damaged.

0:38:590:39:04

Two iPads, a television and some equine equipment, ie a saddle,

0:39:040:39:10

the spine of the saddle, had been broken.

0:39:100:39:12

The claim on this occasion was approximately £4,000.

0:39:120:39:15

It was particularly unfortunate that all the items damaged in the move

0:39:150:39:19

were of high value.

0:39:190:39:21

The claims handler asked the policyholder

0:39:220:39:25

what she'd done with the damaged items.

0:39:250:39:27

The two iPads she'd given to a family member

0:39:270:39:30

with alleged electrical expertise.

0:39:300:39:33

They deemed that both the iPads were beyond repair

0:39:330:39:37

and had disposed of them.

0:39:370:39:40

With the iPads binned,

0:39:400:39:41

there was no way to independently check the level of damage.

0:39:410:39:44

As part of the standard claims procedure,

0:39:460:39:48

she was asked if she had any paperwork

0:39:480:39:50

for the other electrical items.

0:39:500:39:53

She was unable to produce an invoice for the fridge freezer.

0:39:530:39:57

She said she was given that as a gift.

0:39:570:39:59

And there were question marks about the other items

0:39:590:40:02

that had allegedly been damaged.

0:40:020:40:04

What this policy owner was unable to do

0:40:040:40:07

was to produce any meaningful documentation

0:40:070:40:11

which, in the claims handler's view, had any veracity.

0:40:110:40:16

However, the one item that was backed up with an invoice

0:40:160:40:19

was the saddle.

0:40:190:40:21

These concerns meant that her past claims history

0:40:210:40:24

was "trotted" out for inspection.

0:40:240:40:26

It soon transpired that this particular claimant

0:40:260:40:28

had a previous claim two years previous

0:40:280:40:32

in respect of equine products and suspicions were then raised

0:40:320:40:37

in respect of, again, a saddle was being claimed,

0:40:370:40:42

and it's not a cheap product.

0:40:420:40:44

That is putting it mildly.

0:40:440:40:46

The previous claim came to over £10,000 for two saddles.

0:40:460:40:50

This made both claims worth a grand total of £14,000.

0:40:500:40:56

The money at stake warranted close examination of the paperwork.

0:40:560:40:59

Concerns were raised when we looked at the invoices

0:41:010:41:03

and receipts that were put forward.

0:41:030:41:05

There were some basic errors.

0:41:050:41:07

Lack of address, some professional grammatical errors,

0:41:070:41:10

numerical errors.

0:41:100:41:11

There could only be one conclusion.

0:41:120:41:15

The receipts were fraudulent.

0:41:150:41:17

This is a case of greed,

0:41:180:41:20

a means to secure funds from the insurance company,

0:41:200:41:24

Direct Line Group,

0:41:240:41:25

to replace products that they didn't want to pay for themselves.

0:41:250:41:29

But if the policyholder thought she could ride off into the sunset

0:41:290:41:33

with no consequences, she was sorely mistaken.

0:41:330:41:37

Mike and his team passed on their findings to the authorities.

0:41:370:41:40

The policy owner was arrested and interviewed

0:41:400:41:44

in respect of the 2013 claim and the 2014 claim,

0:41:440:41:48

where she has made a full and frank admission of guilt.

0:41:480:41:52

She has been given a police caution with a condition that she repays

0:41:540:41:59

the £14,000 that has been paid by Direct Line Group to her.

0:41:590:42:04

So the odds have dramatically changed

0:42:040:42:06

and she is now going to have to refund her undeserved pay-outs

0:42:060:42:10

for the two claims.

0:42:100:42:11

Unfortunately, this is something that Mike sees all too often.

0:42:110:42:15

Most people who seek to defraud an insurance company

0:42:150:42:19

will utilise the complaints procedure

0:42:190:42:21

as a tactic to frustrate the ongoing investigation.

0:42:210:42:25

It is deemed as a known tactic.

0:42:250:42:27

They view that as, "Well, if they are dealing with a complaint,

0:42:270:42:30

"they will take their eye off the ball."

0:42:300:42:32

Clearly, we did not.

0:42:320:42:33

If anything, it spurred them on.

0:42:330:42:36

This is a case where we have a lady who is of a reasonable standing

0:42:360:42:40

in the community. She now has a tarnished record.

0:42:400:42:43

The message is quite clear.

0:42:430:42:46

Just cos you may have succeeded previously,

0:42:460:42:48

doesn't mean to say you will succeed again.

0:42:480:42:50

And you may find yourself worse off than when you started.

0:42:500:42:53

From organised criminal gangs to exaggerated household claims,

0:42:580:43:02

insurance fraud hits all of us in the pocket.

0:43:020:43:05

But instead of getting away with it,

0:43:050:43:07

more and more of these fraudsters have been claimed and shamed.

0:43:070:43:11

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