0:00:05 > 0:00:09Insurance fraud has reached epidemic levels in the UK.
0:00:09 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:17That's almost 3.6 million every day.
0:00:19 > 0:00:24Deliberate crashes, bogus personal injuries, even phantom pets.
0:00:25 > 0:00:29The fraudsters are risking more and more to make a quick killing
0:00:29 > 0:00:33and, every year, it's adding around £50 to your insurance bill.
0:00:33 > 0:00:35But insurers are fighting back,
0:00:35 > 0:00:39exposing just under 15 fake claims every hour.
0:00:39 > 0:00:42Armed with covert surveillance systems...
0:00:42 > 0:00:44Subject out of the vehicle.
0:00:44 > 0:00:47..sophisticated data analysis techniques...
0:00:47 > 0:00:51- Police!- ..and a number of highly-skilled police units...
0:00:51 > 0:00:53Police! Don't move! Stay where you are!
0:00:53 > 0:00:55..they're catching the criminals red-handed.
0:00:55 > 0:00:56Just don't lie to us.
0:00:58 > 0:01:00All those conmen, scammers and cheats on the fiddle
0:01:00 > 0:01:02are now caught in the act
0:01:02 > 0:01:04and claimed and shamed.
0:01:10 > 0:01:13Today, a man claiming he can't work
0:01:13 > 0:01:17has his supposedly injured back to the wall.
0:01:17 > 0:01:19And you can see him spending hours working on a car,
0:01:19 > 0:01:24bending down, bending over, and he's not in any pain at all.
0:01:25 > 0:01:28A woman who misses her flight tries to stage a cover-up.
0:01:29 > 0:01:34They didn't even provide a taxi for the customer to get to the airport.
0:01:43 > 0:01:47And a claimant's alleged trip isn't caught on camera.
0:01:47 > 0:01:50As can be seen from the CCTV footage,
0:01:50 > 0:01:54no incident's taken place, no-one's fallen over.
0:01:59 > 0:02:02The famous adventurer Thomas Edison once said,
0:02:02 > 0:02:07"there is no substitute for hard work." Simple, but true.
0:02:07 > 0:02:10Most of us know this and apply these principles every day,
0:02:10 > 0:02:12but not insurance cheats.
0:02:12 > 0:02:16They'll take any opportunity to get something for nothing.
0:02:16 > 0:02:19In fact, some fraudsters are so dedicated,
0:02:19 > 0:02:22you could almost call it a career.
0:02:22 > 0:02:27Whether you're a banker, builder, or bus driver, your employer
0:02:27 > 0:02:30will have insurance to protect both you and them
0:02:30 > 0:02:32in the event of an accident.
0:02:33 > 0:02:36Zurich provides exactly this type of cover,
0:02:36 > 0:02:38and it's fraud manager Scott Clayton's job
0:02:38 > 0:02:41to investigate claims that don't quite add up.
0:02:41 > 0:02:44His team recently dealt with a personal injury case
0:02:44 > 0:02:46that raised suspicions.
0:02:47 > 0:02:50This chap had suggested that he'd fallen at work.
0:02:50 > 0:02:53Whilst he was pushing a caravan during the course of his employment,
0:02:53 > 0:02:56he'd slipped on some liquid on the floor.
0:02:56 > 0:02:58According to the claimant, this simple slip
0:02:58 > 0:03:00had done a lot of damage.
0:03:02 > 0:03:05So, he injured his back, his lower leg and was suggesting
0:03:05 > 0:03:09that he had some type of chronic pain syndrome injury.
0:03:09 > 0:03:13The claimant's condition had a huge impact on his day-to-day life.
0:03:15 > 0:03:18He couldn't function properly, he couldn't go to work, he couldn't
0:03:18 > 0:03:22carry out the activities that he could normally do, so, as a result
0:03:22 > 0:03:25of the accident, he was alleging that he was quite severely disabled.
0:03:25 > 0:03:28With ongoing symptoms as severe as this,
0:03:28 > 0:03:30Zurich were looking at a huge pay-out.
0:03:30 > 0:03:31The value of this claim,
0:03:31 > 0:03:34when you consider the compensation for his injury,
0:03:34 > 0:03:37his previous loss of earnings, his future loss of earnings,
0:03:37 > 0:03:40care, it was round about half a million pounds.
0:03:40 > 0:03:44But before a penny of the half a million pounds was paid,
0:03:44 > 0:03:48Scott needed to put some concerns about the claim to rest.
0:03:48 > 0:03:52We had suspicions about this claim, because this chap
0:03:52 > 0:03:54was suggesting that he was severely injured.
0:03:54 > 0:03:57And the medical records didn't really tally up in terms of his
0:03:57 > 0:03:59future prognosis and what was wrong,
0:03:59 > 0:04:03so we decided to put him under surveillance and find out
0:04:03 > 0:04:06exactly what he was able to and not able to do.
0:04:06 > 0:04:10The medical report suggested that the claimant stopped work due
0:04:10 > 0:04:14to a stress-related illness rather than his physical condition.
0:04:14 > 0:04:19So the surveillance would establish whether or not this was the case.
0:04:19 > 0:04:23There's an element of satisfaction, but surprise when you get
0:04:23 > 0:04:26surveillance footage through that's as revealing as this.
0:04:30 > 0:04:33So, in this particular case, you can see that he's
0:04:33 > 0:04:35loading a cement mixer,
0:04:35 > 0:04:38it would appear as if he's doing some sort of building work.
0:04:41 > 0:04:43But it's certainly manual labour,
0:04:43 > 0:04:46and for someone who's got a significant back injury,
0:04:46 > 0:04:49that completely contradicts what we're seeing in the medical reports.
0:04:49 > 0:04:52With the foundations of this case crumbling,
0:04:52 > 0:04:55his next act would leave the claim all washed up.
0:04:55 > 0:04:57We can see the claimant working as,
0:04:57 > 0:04:59it would appear to be a car valeter.
0:05:01 > 0:05:04And you can see him spending hours working on a car,
0:05:04 > 0:05:08bending down, bending over and he's not in any pain at all.
0:05:08 > 0:05:10This is somebody who doesn't appear to be injured
0:05:10 > 0:05:12or suffering in any way.
0:05:14 > 0:05:17For somebody who's trying to claim half a million pounds,
0:05:17 > 0:05:20this surveillance evidence blows his claim out of the water,
0:05:20 > 0:05:24- so it just goes to show how crucial it can be.- Too right.
0:05:24 > 0:05:27But Scott wanted to be absolutely sure they hadn't just caught
0:05:27 > 0:05:29the claimant on a good day.
0:05:29 > 0:05:33Because we carried out three separate periods of surveillance
0:05:33 > 0:05:36over a number of dates, then it's clear, unequivocally,
0:05:36 > 0:05:39that this person isn't injured anywhere near
0:05:39 > 0:05:42the extent that he claims he was on that day.
0:05:42 > 0:05:45It was the conclusive proof Scott needed.
0:05:45 > 0:05:49The claimant was as fit as an insurance fiddler.
0:05:49 > 0:05:51The surveillance evidence was absolutely dynamite,
0:05:51 > 0:05:57because it provides us with a true account of this person's disability,
0:05:57 > 0:05:58which, in this case, proved that
0:05:58 > 0:06:02there was nothing really wrong with him.
0:06:02 > 0:06:03The team at Zurich believe
0:06:03 > 0:06:05they have their claimant bang to rights,
0:06:05 > 0:06:08and Scott had to decide his next move.
0:06:08 > 0:06:12Armed with this evidence, we had to make a call in terms of the
0:06:12 > 0:06:15true value of the claim against what he was claiming.
0:06:15 > 0:06:18We assessed the true value to be roundabout £5,000,
0:06:18 > 0:06:23but by that time, we'd incurred so much costs and solicitors fees,
0:06:23 > 0:06:24as had he,
0:06:24 > 0:06:28which would ultimately completely dwarf any settlement figure.
0:06:28 > 0:06:32The combined costs at this point were close to £100,000.
0:06:32 > 0:06:33With this in mind,
0:06:33 > 0:06:37the surveillance footage was passed on to the claimant's solicitors.
0:06:37 > 0:06:40I can only imagine the shock that they were under
0:06:40 > 0:06:43when they saw the footage, because clearly it displays somebody
0:06:43 > 0:06:45who's submitting a fraudulent claim.
0:06:45 > 0:06:50Unsurprisingly, the video evidence wasn't contested, but there was
0:06:50 > 0:06:53no way the claimant was walking away from this scot-free.
0:06:53 > 0:06:57He was caught. The penalties for being caught were severe,
0:06:57 > 0:07:01because he had to pay our legal costs, his legal costs...
0:07:01 > 0:07:07We estimated our cost to be in the region of £36,000.
0:07:07 > 0:07:10Well, that's not it, because he's got his own solicitor's costs
0:07:10 > 0:07:14to pay as well, which we believe are in the region of £40,000.
0:07:14 > 0:07:16If the claimant had been honest,
0:07:16 > 0:07:19he would've received fair compensation,
0:07:19 > 0:07:22instead of facing a bill of around £80,000,
0:07:22 > 0:07:24and the threat of going to court.
0:07:26 > 0:07:29He could've settled this claim for £5,000 long ago
0:07:29 > 0:07:31and it would've been done and dusted,
0:07:31 > 0:07:32but instead, he decided to lie,
0:07:32 > 0:07:35exaggerate the effects of this injury and ultimately try
0:07:35 > 0:07:38and achieve a life-changing sum of money.
0:07:38 > 0:07:43When it comes to this type of claim, Scott's position is crystal clear.
0:07:43 > 0:07:45This is an example of gross exaggeration,
0:07:45 > 0:07:49a £5,000 claim that he was suggesting was worth half a million,
0:07:49 > 0:07:52they don't come more bullish than that.
0:07:52 > 0:07:56The implications for him financially should serve as a lesson to people.
0:07:56 > 0:07:59Despite successfully stopping this claim in its tracks,
0:07:59 > 0:08:03ultimately there are no winners in cases like this.
0:08:03 > 0:08:07We were pleased with the outcome, because justice was in effect done.
0:08:07 > 0:08:10What disappoints you though is the time and effort
0:08:10 > 0:08:13that goes into these cases, because he decided to lie.
0:08:20 > 0:08:22Still to come...
0:08:22 > 0:08:26A lorry driver fabricates an illness to claim loss of earnings
0:08:26 > 0:08:27on a made-up career.
0:08:28 > 0:08:32He had signed fake doctors' notes,
0:08:32 > 0:08:34he had pretended to be managers,
0:08:34 > 0:08:38owners of haulage companies all to try and claim this £56,000.
0:08:39 > 0:08:43And two insurance cheats are caught in the act staging a car crash.
0:08:45 > 0:08:47I think having been warned by the police,
0:08:47 > 0:08:51we were really surprised that the claims were still presented.
0:09:05 > 0:09:07From foreign currency to vaccinations,
0:09:07 > 0:09:10there is a lot to remember when you're going abroad.
0:09:10 > 0:09:13Choosing an appropriate travel insurance policy
0:09:13 > 0:09:15is top of most travellers' lists.
0:09:15 > 0:09:18Unfortunately, there are people out there who don't bother with
0:09:18 > 0:09:21the right level of cover and attempted to lie about
0:09:21 > 0:09:25the circumstances of a claim when something goes wrong.
0:09:25 > 0:09:27This, quite simply, is fraud.
0:09:28 > 0:09:31Whether it's sun, sea, siestas, adventure,
0:09:31 > 0:09:35or quiet contemplation you seek during your great escape,
0:09:35 > 0:09:38there'll be a policy to cover you on your travels.
0:09:40 > 0:09:43Simon Cook is head of special investigations
0:09:43 > 0:09:45for travel services provider Cega.
0:09:45 > 0:09:50It's his job to spot the holiday scams from the genuine claims.
0:09:50 > 0:09:53One of the cases that landed on his desk involved a customer
0:09:53 > 0:09:57who'd run into trouble returning from France.
0:09:57 > 0:09:59For this particular claim,
0:09:59 > 0:10:03the customer contacted us to make a claim for missed departure.
0:10:03 > 0:10:07Unfortunately, the taxi that she was travelling in to the airport
0:10:07 > 0:10:11got caught in heavy traffic, so she couldn't catch her scheduled flight.
0:10:11 > 0:10:15The value of the claim was around £500 for a new flight.
0:10:15 > 0:10:17A real holiday headache.
0:10:17 > 0:10:20But thankfully, that's what insurance is for.
0:10:20 > 0:10:23In order to consider a claim for missed departure,
0:10:23 > 0:10:26we just need some form of independent proof
0:10:26 > 0:10:30to substantiate the circumstances that the customer presented to us.
0:10:30 > 0:10:32In this case, maybe a letter from the taxi company
0:10:32 > 0:10:35confirming what happened.
0:10:35 > 0:10:37An understandable request,
0:10:37 > 0:10:39and the claimant promptly provided it.
0:10:40 > 0:10:44In support of the claim, the customer provided us with an e-mail,
0:10:44 > 0:10:48purportedly from the taxi company confirming that they were
0:10:48 > 0:10:52stuck in traffic and they couldn't get to the airport on time.
0:10:52 > 0:10:55It seemed like a straightforward claim to process.
0:10:55 > 0:10:59But the proof provided was sending a few different messages.
0:10:59 > 0:11:02We were immediately concerned with the e-mail that we received
0:11:02 > 0:11:04from the customer to support the claim,
0:11:04 > 0:11:07as it was riddled with irregularities
0:11:07 > 0:11:09and grammatical errors.
0:11:12 > 0:11:15The claimant was contacted by a member of Simon's team
0:11:15 > 0:11:18to clear up the confusion.
0:11:53 > 0:11:55Not convinced by the claimant's story,
0:11:55 > 0:11:58Simon's team continued with their enquiries.
0:11:58 > 0:12:00After speaking with the customer about this,
0:12:00 > 0:12:02we decided to speak with the taxi company,
0:12:02 > 0:12:06who then told us that they didn't actually issue the e-mail.
0:12:07 > 0:12:09Worrying information.
0:12:09 > 0:12:12Armed with this knowledge, the claimant is questioned further.
0:12:42 > 0:12:44We disclosed the evidence to the customer.
0:12:44 > 0:12:49She professed that a French driver had in fact sent her the e-mail,
0:12:49 > 0:12:52which could account for the grammatical errors.
0:13:10 > 0:13:15Simon's team got back in touch with the owner of the transfer firm
0:13:15 > 0:13:19and this revealed more shocking information.
0:13:19 > 0:13:23It was evident that the customer had in fact contacted this taxi company
0:13:23 > 0:13:26and asked them to provide her with falsified evidence
0:13:26 > 0:13:28to support her insurance claim.
0:13:28 > 0:13:32They didn't even provide a taxi for the customer to get to the airport.
0:13:32 > 0:13:35Despite the claimant's robust denial,
0:13:35 > 0:13:38the evidence clearly suggested that, after the taxi firm had
0:13:38 > 0:13:42refused to fabricate an e-mail to validate her bogus story,
0:13:42 > 0:13:45she'd just gone ahead and done it herself anyway.
0:13:45 > 0:13:49And it was this forged e-mail that was forwarded on to Simon's team.
0:14:28 > 0:14:32While somebody had edited the e-mail before it was received by Cega,
0:14:32 > 0:14:35reviewing the evidence suggested the claimant
0:14:35 > 0:14:37was attempting an elaborate scam.
0:14:39 > 0:14:42The e-mails confirmed that the customer had tried to get the
0:14:42 > 0:14:45taxi company to falsely give her some information in writing
0:14:45 > 0:14:47to support her claim.
0:14:47 > 0:14:50Despite the claimant firmly denying this information,
0:14:50 > 0:14:54Simon was certain about one key fact.
0:14:56 > 0:15:00We have no idea what the true reason was why the customer missed
0:15:00 > 0:15:03her international flight home, but what we do know is that
0:15:03 > 0:15:06it definitely didn't have anything to do with
0:15:06 > 0:15:08a taxi getting caught up in heavy traffic.
0:15:09 > 0:15:11Given the overwhelming evidence,
0:15:11 > 0:15:14Simon's next decision would be straightforward.
0:15:14 > 0:15:18The final correspondence we had with the customer was explaining
0:15:18 > 0:15:21that we weren't satisfied that the e-mail she provided to us
0:15:21 > 0:15:25was genuine and that was borne out by the fact that the taxi company
0:15:25 > 0:15:28had said they didn't issue it and she didn't even have
0:15:28 > 0:15:30a taxi booked with them to travel to the airport.
0:15:30 > 0:15:33The claim was declined in full.
0:15:33 > 0:15:35And this was relayed to the claimant.
0:15:59 > 0:16:02The situation is that her claim had been deemed to be false.
0:16:03 > 0:16:05She wouldn't be receiving a penny
0:16:05 > 0:16:07and was lucky to avoid further action.
0:16:09 > 0:16:12This customer actually went one step further
0:16:12 > 0:16:14than just exaggerating her claim.
0:16:14 > 0:16:17She's actually falsified a document to support the claim.
0:16:17 > 0:16:21This isn't behaviour Simon is willing to put up with.
0:16:21 > 0:16:24Providing a false device in support of an insurance claim
0:16:24 > 0:16:26is simply not acceptable.
0:16:35 > 0:16:38Whether it's a closed road or noisy builders next door,
0:16:38 > 0:16:42most of us have experienced the inconvenience of maintenance works.
0:16:42 > 0:16:46However, for fraudsters, these things can be seen as an opportunity
0:16:46 > 0:16:49to make a bogus personal injury claim.
0:16:50 > 0:16:53In recent years, there's been a boom when it comes to people
0:16:53 > 0:16:56making these types of claims.
0:16:58 > 0:17:01Whether it be slips, trips...
0:17:02 > 0:17:04..or motoring mishaps.
0:17:05 > 0:17:09Insurers Allianz deal with these claims on a daily basis.
0:17:09 > 0:17:12And their fraud manager, Mihir Pandya,
0:17:12 > 0:17:16is an expert at weeding out the spurious ones from the genuine.
0:17:16 > 0:17:20He was asked to look into a case from a commercial customer
0:17:20 > 0:17:22worth several thousand pounds.
0:17:23 > 0:17:27We were contacted by our policyholder,
0:17:27 > 0:17:30who owned a local convenience store,
0:17:30 > 0:17:33telling us that a customer a month prior had fallen
0:17:33 > 0:17:38into a trench that was outside his store and injured himself.
0:17:38 > 0:17:43Oh, dear. Not what you'd expect when you're picking up a pint of milk.
0:17:43 > 0:17:45Once Allianz had spoken to the shop owner
0:17:45 > 0:17:48it seemed like an open-and-shut case.
0:17:50 > 0:17:53The owner of the local convenience store confirmed
0:17:53 > 0:17:55that there were indeed works going on outside.
0:17:55 > 0:17:57There was a trench.
0:17:57 > 0:18:02It had been dug out for some work to be done to a water mains connection.
0:18:02 > 0:18:06But what he told us was that there were barriers placed there daily,
0:18:06 > 0:18:08but on occasion, those barriers would be moved.
0:18:08 > 0:18:11And if those barriers weren't in position
0:18:11 > 0:18:13warning passers-by to the hazard,
0:18:13 > 0:18:17then the shop owner would be liable for the claimant's injuries.
0:18:18 > 0:18:23The alleged injuries sustained were a broken left big toe,
0:18:23 > 0:18:28bruising and swelling to the feet and also unspecified injuries
0:18:28 > 0:18:30to the individual's knee.
0:18:31 > 0:18:34It looked like Allianz would be paying out.
0:18:35 > 0:18:39Well, that was until the claimant's medical records were received.
0:18:42 > 0:18:45Now, within the medical notes, there was indication
0:18:45 > 0:18:50that the individual had history of falling over
0:18:50 > 0:18:57and there were pre-existing injuries being alluded to within the report.
0:18:57 > 0:18:59There was no mention of the alleged incident
0:18:59 > 0:19:01or that he had fallen into a trench.
0:19:01 > 0:19:04Odd that, considering the alleged injuries
0:19:04 > 0:19:06were the direct result of the accident.
0:19:08 > 0:19:10And further examination would leave the claimant
0:19:10 > 0:19:12without a leg to stand on.
0:19:13 > 0:19:17It was also apparent that the individual had not sustained
0:19:17 > 0:19:20injuries by falling into a trench.
0:19:20 > 0:19:23There was indeed confirmation within that report that, three days
0:19:23 > 0:19:27prior to the alleged incident date, he'd dropped something heavy on his
0:19:27 > 0:19:31foot, which was probably the reason why he sustained a broken toe.
0:19:32 > 0:19:35Allianz had all the proof they needed to make a decision.
0:19:35 > 0:19:40On the back of the information that we had in our possession, we felt
0:19:40 > 0:19:44confident we had enough information to decline the claim, which we did.
0:19:46 > 0:19:49But that wouldn't be the last Allianz
0:19:49 > 0:19:50would hear from the claimant.
0:19:51 > 0:19:56We thought that was the end of the matter, but six months later,
0:19:56 > 0:20:01we received communication from the claimant's solicitors telling us
0:20:01 > 0:20:05that they would be prepared to accept a far reduced offer.
0:20:06 > 0:20:09As far as we were concerned, nothing had changed,
0:20:09 > 0:20:12so we maintained our position and refused to pay the claim.
0:20:12 > 0:20:15But the claimant obviously thought three time's a charm.
0:20:16 > 0:20:21Surprisingly, the claimant still wanted to pursue the claim
0:20:21 > 0:20:24and threatened to take us to court.
0:20:24 > 0:20:27We weren't going to just roll over,
0:20:27 > 0:20:29so we accepted that action
0:20:29 > 0:20:34and a trial date was set for December 2015.
0:20:35 > 0:20:39Solicitors Keoghs were instructed to defend the claim.
0:20:40 > 0:20:43Insurance law expert, Nina Dayal, took the case on.
0:20:44 > 0:20:48And there was one piece of crucial evidence to be examined.
0:20:48 > 0:20:52Fundamentally to this case, the policyholder had preserved
0:20:52 > 0:20:56the CCTV footage which was going to provide a defence to the case.
0:20:57 > 0:21:00Keen to see the incident for themselves, they reviewed the
0:21:00 > 0:21:03footage from the day the claimant was alleged to have fallen.
0:21:05 > 0:21:07The CCTV evidence is quite clear.
0:21:07 > 0:21:12It shows a number of people walking past without any incident.
0:21:12 > 0:21:15There are walkers, cyclists, people pushing prams.
0:21:15 > 0:21:21But no claimant having a fall in the manner described and alleged.
0:21:21 > 0:21:25But he had succeeded in framing himself for a false claim.
0:21:26 > 0:21:29As can be seen from the CCTV footage,
0:21:29 > 0:21:33no incident has taken place, no-one has fallen over.
0:21:34 > 0:21:36It was damning evidence
0:21:36 > 0:21:39and all attention turned to the forthcoming day in court.
0:21:39 > 0:21:44Prior to the trial, the claimant's solicitors
0:21:44 > 0:21:48removed themselves off the court's record.
0:21:48 > 0:21:51Consequently, the claimant was left without
0:21:51 > 0:21:54any legal representation days before the trial.
0:21:54 > 0:21:58A telling decision and the claimant would soon follow suit.
0:22:00 > 0:22:03The trial on the 7th December was vacated
0:22:03 > 0:22:05and re-enlisted for a hearing.
0:22:05 > 0:22:08The claimant was given the opportunity to attend,
0:22:08 > 0:22:10but failed to do so.
0:22:10 > 0:22:13Consequently, his claim was struck out.
0:22:13 > 0:22:16The judge reviewed the evidence extensively
0:22:16 > 0:22:20and made no hesitation in making a finding that the claimant
0:22:20 > 0:22:22was fundamentally dishonest.
0:22:22 > 0:22:25It was an important decision for Mihir and his team.
0:22:27 > 0:22:30A finding of fundamental dishonesty is significant in these cases,
0:22:30 > 0:22:33since it allows the defendants to seek recoverability
0:22:33 > 0:22:36of those costs from the claimant directly.
0:22:36 > 0:22:43In this case, the claimant was ordered to pay a sum of £15,468.90.
0:22:44 > 0:22:48This case clearly shows that, for those considering pulling
0:22:48 > 0:22:51a personal injury scam, it just isn't worth it.
0:22:51 > 0:22:56This was a really brazen attempt by the claimant
0:22:56 > 0:23:00and the fact that he took this to court to try and take us on
0:23:00 > 0:23:03would suggest he wasn't very bright.
0:23:09 > 0:23:12Now, an insurance policy can cover the cost of unforeseen problems.
0:23:12 > 0:23:16Everything from car accidents to medical bills while you're abroad
0:23:16 > 0:23:19and even lost income from unemployment.
0:23:19 > 0:23:22But while for most of us making a claim is a last resort,
0:23:22 > 0:23:25there are fraudsters out there who view these policies
0:23:25 > 0:23:27as a way to fund an early retirement.
0:23:29 > 0:23:31Insurers Cardif Pinnacle offer cover to customers
0:23:31 > 0:23:33looking for peace of mind.
0:23:36 > 0:23:39What they don't provide or tolerate is insurance cheats looking
0:23:39 > 0:23:42to cash in on a policy with a fraudulent claim.
0:23:43 > 0:23:45Any suspect cases are investigated
0:23:45 > 0:23:49and, if necessary, referred to the City of London Police's
0:23:49 > 0:23:51Insurance Fraud Enforcement Department.
0:23:53 > 0:23:57DC Jamie Kirk was passed one case that needed a detective's eye.
0:23:59 > 0:24:02Mark Downs accepted two income protection policies
0:24:02 > 0:24:04with Cardif Pinnacle.
0:24:04 > 0:24:07These were in case he was unable to work.
0:24:07 > 0:24:10So, if he was unable to work, they would provide
0:24:10 > 0:24:13a level of cover to cover his salary.
0:24:13 > 0:24:16The total claim that would have been paid out over the course of a year
0:24:16 > 0:24:20would have been to the sum of £56,000.
0:24:20 > 0:24:22And it wouldn't be long before Downs
0:24:22 > 0:24:24would have to call upon these policies.
0:24:25 > 0:24:31He made claims on these very shortly after having accepted the policies.
0:24:31 > 0:24:36One of those actually showed that he had been not working
0:24:36 > 0:24:39at the time he accepted one of those policies.
0:24:39 > 0:24:42So Cardif Pinnacle were immediately suspicious.
0:24:42 > 0:24:44It was only a matter of months
0:24:44 > 0:24:47between taking out the insurance cover
0:24:47 > 0:24:50and first attempting to make a claim on medical grounds.
0:24:50 > 0:24:54With both the policies that Mark Downs had with Cardif Pinnacle,
0:24:54 > 0:24:57he was claiming that he was suffering from ulcerated colitis.
0:24:57 > 0:25:02Which is a particularly nasty enlarging of the bowels and colon.
0:25:02 > 0:25:04And upon looking into Downs' work history,
0:25:04 > 0:25:07it appeared he had been less than truthful.
0:25:09 > 0:25:13Mark Downs had claimed that he was working for a Dutch haulage company.
0:25:13 > 0:25:17He also claimed that he owned a Dutch haulage company.
0:25:17 > 0:25:20He always claimed to be a managing director,
0:25:20 > 0:25:22even the owner of the company.
0:25:22 > 0:25:26We spoke to the actual managing director, who assured us that
0:25:26 > 0:25:29Mark Downs was not a manager, although he had worked there,
0:25:29 > 0:25:32albeit some years before the claim was ever submitted.
0:25:34 > 0:25:38So he was claiming loss of earnings on a job he didn't even have.
0:25:40 > 0:25:43Downs had also submitted evidence alleging
0:25:43 > 0:25:45he owned numerous haulage companies.
0:25:46 > 0:25:49But when detectives checked out the office at addresses provided,
0:25:49 > 0:25:52no trace of the businesses could be found.
0:25:53 > 0:25:57Mark Downs had previously been a lorry driver,
0:25:57 > 0:26:00and that was the business he knew,
0:26:00 > 0:26:03which is the reason I believe why he kept claiming to be
0:26:03 > 0:26:09the manager or the owner or someone senior in various haulage companies.
0:26:09 > 0:26:13In support of his £56,000 claim, Downs had also submitted
0:26:13 > 0:26:17medical records reportedly from his examining doctors.
0:26:18 > 0:26:20They were able to tell us
0:26:20 > 0:26:23that they hadn't ever provided these doctors notes.
0:26:23 > 0:26:25The doctors notes were fraudulent.
0:26:25 > 0:26:27They hadn't operated from the various places
0:26:27 > 0:26:31that he stated GP surgeries were.
0:26:31 > 0:26:34And they also were able to tell us that he wasn't suffering from
0:26:34 > 0:26:37the illness that he was claiming from either.
0:26:37 > 0:26:39Mark Downes's lies had been exposed
0:26:39 > 0:26:43along with the fake documents he had been providing to his insurer.
0:26:43 > 0:26:45His attempted scam had failed.
0:26:47 > 0:26:50There was an awful lot of evidence against Mark Downes.
0:26:50 > 0:26:54We were able to show that the claims he had made were
0:26:54 > 0:26:59completely fraudulent, that he had pretended to be at doctors.
0:26:59 > 0:27:03He had signed fake doctors' notes.
0:27:03 > 0:27:05He had pretended to be managers,
0:27:05 > 0:27:07owners of haulage companies.
0:27:07 > 0:27:10All to try and claim £56,000.
0:27:10 > 0:27:14And it wouldn't be long before this assurance cheat would have
0:27:14 > 0:27:15to answer for his actions.
0:27:18 > 0:27:22Mark Downes was arrested at his home address in Kent.
0:27:22 > 0:27:24His house was searched
0:27:24 > 0:27:27where we found various documentation,
0:27:27 > 0:27:30fraudulent doctors' notes
0:27:30 > 0:27:34and other documentation relating to the insurance claim.
0:27:34 > 0:27:37Despite the overwhelming body of evidence, there would be
0:27:37 > 0:27:38no confession.
0:27:41 > 0:27:42He was interviewed
0:27:42 > 0:27:45where he denied that the claim was fraudulent.
0:27:45 > 0:27:49He stated that it was all a genuine claim, that all the doctors' notes
0:27:49 > 0:27:53were genuine and maintained his innocence throughout.
0:27:53 > 0:27:56With Downes in custody and facing multiple fraud charges,
0:27:56 > 0:27:59his case took an unexpected turn.
0:27:59 > 0:28:03After Mark Downes's initial arrest
0:28:03 > 0:28:06and his first interview, he was bailed.
0:28:06 > 0:28:12It was after that point that we spoke to another insurance company.
0:28:12 > 0:28:16We were able to identify two almost identical policies to
0:28:16 > 0:28:19the two policies he'd taken out with Cardif Pinnacle.
0:28:19 > 0:28:23And exactly the same fraud had been going on with Shepherds Friendly.
0:28:23 > 0:28:26Things were going from bad to worse for Mark Downes
0:28:26 > 0:28:31and the full extent of his attempted fraud had been revealed.
0:28:31 > 0:28:34He clearly thought he was never ever going to get caught and
0:28:34 > 0:28:39he thought he was going to get £56,000 from Cardif Pinnacle
0:28:39 > 0:28:42and a further £40,000 from Shepherds Friendly, which again
0:28:42 > 0:28:46he was not entitled to as it was a completely made up set of claims.
0:28:46 > 0:28:50With false claims totalling nearly £100,000,
0:28:50 > 0:28:53Downes was charged with 12 counts of fraud.
0:28:53 > 0:28:54He pled guilty at trial...
0:28:56 > 0:28:59..and was sentenced to 14 months in prison.
0:29:02 > 0:29:06The 14-month custodial sentence, which Mark Downes received,
0:29:06 > 0:29:11I feel reflects the level of fraud,
0:29:11 > 0:29:14the fact that he was pretending to be a doctor
0:29:14 > 0:29:18and it reflects the amount that he stood to make, almost £100,000.
0:29:18 > 0:29:20If Downes hadn't been stopped when he was,
0:29:20 > 0:29:23the consequences could have been grave.
0:29:23 > 0:29:30Mark Downes has previous convictions for fraud and like offences.
0:29:30 > 0:29:35I believe, if we hadn't been able to catch him on this occasion,
0:29:35 > 0:29:38he would still be out committing fraud right now.
0:29:43 > 0:29:46Now, you might have looked at your old banger of a car
0:29:46 > 0:29:49and longed for a little sporty roadster.
0:29:49 > 0:29:51For most, it's just a dream.
0:29:51 > 0:29:54Insurance cheats, on the other hand, think that staging a crash
0:29:54 > 0:29:57with their old motor and passing it off as a genuine accident
0:29:57 > 0:30:01will get them an upgraded car courtesy of their insurers.
0:30:02 > 0:30:03Big mistake.
0:30:04 > 0:30:09With over 300 billion miles covered every year by UK drivers,
0:30:09 > 0:30:11accidents, unfortunately...
0:30:12 > 0:30:14..are just a fact of motoring life.
0:30:15 > 0:30:18Thankfully, companies like Insure The Box offer insurance cover
0:30:18 > 0:30:22to protect customers against most motoring mishaps.
0:30:23 > 0:30:26They operate a zero tolerance policy towards fraud,
0:30:26 > 0:30:29as one of their recent cases demonstrates.
0:30:31 > 0:30:33The two individuals alleged that
0:30:33 > 0:30:36there was this road traffic incident.
0:30:36 > 0:30:40Our customer claimed they were turning round a junction,
0:30:40 > 0:30:44didn't see the other party and it was entirely their fault.
0:30:44 > 0:30:47The two cars had collided, resulting in quite an impact.
0:30:48 > 0:30:52But there was some shocking evidence which called the legitimacy
0:30:52 > 0:30:53of the claim into question.
0:30:55 > 0:30:59So an independent witness heard a bang in the middle of the night,
0:30:59 > 0:31:05looked out the window and saw two men chatting amicably
0:31:05 > 0:31:07and then one man got into a vehicle,
0:31:07 > 0:31:12reversed out and crashed his car into the other car again.
0:31:12 > 0:31:16Both men got out of the vehicles, again were chatting amicably.
0:31:16 > 0:31:17Under cover of darkness,
0:31:17 > 0:31:20the witness had observed Luke Gaughan and Sam Borbely
0:31:20 > 0:31:24staging a deliberate collision using their two cars.
0:31:25 > 0:31:29The police turned up to the scene and warned both individuals
0:31:29 > 0:31:32that, if they pursued a claim, they would likely to be
0:31:32 > 0:31:35blacklisted from insurance and that that would be an offence.
0:31:36 > 0:31:40It's not actually illegal to damage your own vehicle, but passing
0:31:40 > 0:31:44off that damage as the result of a genuine accident and then
0:31:44 > 0:31:48submitting a fourth claim is insurance fraud.
0:31:48 > 0:31:50But, at first, it appeared as if
0:31:50 > 0:31:53Borbely had taken the police officers' warning on board.
0:31:53 > 0:31:57So our customer called us a couple of days after the alleged incident
0:31:57 > 0:32:00and he informed us that he had already taken his vehicle
0:32:00 > 0:32:03to a scrapyard and he wasn't going to be pursuing a claim.
0:32:04 > 0:32:08But Gaughan, who was the driver of the third party vehicle,
0:32:08 > 0:32:10wouldn't be deterred so easily.
0:32:10 > 0:32:15And submitted claims for personal injury and damage to both vehicles.
0:32:15 > 0:32:19Our customer said the other party had neck and wrist injuries.
0:32:20 > 0:32:24This claim would have been worth approximately £7,000.
0:32:24 > 0:32:27So at this stage, Borbely, Insure The Box's customer,
0:32:27 > 0:32:30has already said that he was at fault for the alleged accident.
0:32:30 > 0:32:34While he's not pursuing any insurance claims, he is assisting
0:32:34 > 0:32:38the claims of his crash buddy and the third party driver Gaughan,
0:32:38 > 0:32:41which the evidence suggests are completely fraudulent.
0:32:41 > 0:32:44But any chance the duo had of pulling off their scam
0:32:44 > 0:32:46was soon scuppered.
0:32:47 > 0:32:49When confronted with the overwhelming evidence,
0:32:49 > 0:32:53our policyholder made a full confession.
0:32:53 > 0:32:56However, the other driver continued with the claim,
0:32:56 > 0:33:00even went to an accident management company and, when Insure The Box
0:33:00 > 0:33:04refused to pay the claim, went after his own insurers, Aviva.
0:33:04 > 0:33:07It would be a road Gaughan would regret going down
0:33:07 > 0:33:11as he was up against Aviva's Head Of Fraud, Tom Gardiner.
0:33:11 > 0:33:14By this point, Aviva were fully up to speed
0:33:14 > 0:33:17with the pair's attempted car crash con.
0:33:18 > 0:33:21I think, having been warned by the police and knowing there was
0:33:21 > 0:33:24a witness to the event,
0:33:24 > 0:33:27we were really surprised that claims were still presented.
0:33:51 > 0:33:55He obviously didn't hear the police advising him
0:33:55 > 0:33:56not to make a claim.
0:34:14 > 0:34:17While the claim was repudiated immediately,
0:34:17 > 0:34:19as it was known to be false,
0:34:19 > 0:34:23and Gaughan seemed slightly confused about who hit whom.
0:34:24 > 0:34:27Despite this, Gaughan continued to lie to the call handler.
0:34:51 > 0:34:53Try as he might to push his claim,
0:34:53 > 0:34:56Gaughan's efforts were met with a sobering response.
0:34:58 > 0:35:03We'd already flagged the policy on the back of the information that
0:35:03 > 0:35:07the police had given us, so, when a claim was intimated,
0:35:07 > 0:35:10it was declined straight away.
0:35:10 > 0:35:13Undeterred, Gordon continued to try it on.
0:35:32 > 0:35:36Well, insurers are under no obligation to play false claims.
0:35:36 > 0:35:40Borbely had already admitted to his own insurer that the accident
0:35:40 > 0:35:44was staged and Ifed's investigations prove that
0:35:44 > 0:35:48and also that Gaughan and Borbely had been friends for some time.
0:35:49 > 0:35:52At least they had each other when the full weight of the law
0:35:52 > 0:35:54came crashing down on them.
0:35:55 > 0:36:00Both men were charged with fraud. They were both prosecuted
0:36:00 > 0:36:04and they both received four-month suspended sentences.
0:36:04 > 0:36:07They had to paid £1,200 costs and they also
0:36:07 > 0:36:10got 100 hours community service.
0:36:10 > 0:36:15As far as Tom's concerned, the punishment fitted the crime.
0:36:15 > 0:36:19Pretty blatant and clearly poorly planned fraud.
0:36:19 > 0:36:21Not only were they seen by a witness,
0:36:21 > 0:36:23they were warned by the police
0:36:23 > 0:36:26and, eventually, prosecution is what they both deserved.
0:36:27 > 0:36:29And it's not just insurers
0:36:29 > 0:36:33who aren't prepared to tolerate this type of scam any more.
0:36:34 > 0:36:36We were pleased with the result.
0:36:36 > 0:36:40I think what this shows is, by the action of the witness,
0:36:40 > 0:36:45that the public really are just fed up paying for motor insurance fraud.
0:36:45 > 0:36:48I think it shows the level of collaboration between insurers
0:36:48 > 0:36:51and police and I think it shows
0:36:51 > 0:36:55that, even for a relatively minor incident,
0:36:55 > 0:36:59we're still prepared and we will prosecute cases of insurance fraud.
0:37:05 > 0:37:08Now, we've heard about some of the types of scams UK fraudsters
0:37:08 > 0:37:12will attempt to get their hands on a pay out they're not entitled to.
0:37:12 > 0:37:15But in America, there have been fraudsters who will go to
0:37:15 > 0:37:19extraordinary lengths that you would scarcely believe possible
0:37:19 > 0:37:21until faced with the shocking facts.
0:37:28 > 0:37:29New York.
0:37:29 > 0:37:32One of America's most iconic cities
0:37:32 > 0:37:35and home to the big-hearted Louis "Buddy" Musso.
0:37:37 > 0:37:41The 59-year-old grocery bagger with severe learning difficulties.
0:37:42 > 0:37:45Buddy dreamt of being a country and western singer.
0:37:45 > 0:37:48He also longed to meet a special someone.
0:37:49 > 0:37:53In 1997, he thought at least one of his dreams had come true when
0:37:53 > 0:37:58he met 44-year-old Texan Suzanne Basso at a church carnival.
0:38:00 > 0:38:03She befriended Buddy and he quickly became smitten with her.
0:38:03 > 0:38:06Just after a year into their long-distance relationship,
0:38:06 > 0:38:10Suzanne invited Buddy to move to Texas to be with her.
0:38:12 > 0:38:15Buddy was over the moon and accepted.
0:38:15 > 0:38:18Little did he know he was walking into a deadly trap.
0:38:23 > 0:38:27In 1998, Buddy left friends and family behind, travelled to
0:38:27 > 0:38:32Texas and moved in with Suzanne and her 22-year-old son, James O'Malley.
0:38:35 > 0:38:38Basso was now ready to execute the next stage of her plan.
0:38:40 > 0:38:43In secret, she fraudulently took out
0:38:43 > 0:38:46a 15,000 life insurance policy on Buddy...
0:38:48 > 0:38:50..making herself the sole beneficiary.
0:38:53 > 0:38:56A clause was included which stated, if Buddy were to die
0:38:56 > 0:39:01a violent death, then the policy would increase to 65,000.
0:39:01 > 0:39:03Horrifically, this was a clause
0:39:03 > 0:39:07that Basso was determined to bring into effect.
0:39:11 > 0:39:14Basso, her son James and a group of conspirators
0:39:14 > 0:39:17started to take advantage of Buddy's good nature.
0:39:19 > 0:39:22He was forced to wait on them hand and foot.
0:39:27 > 0:39:30And he never questioned anything he was asked to do.
0:39:30 > 0:39:33Rapidly, his treatment deteriorated.
0:39:36 > 0:39:41He was treated like a dog. Even a forced to kneel when he slept.
0:39:42 > 0:39:47If he tried to lie down, he was beaten by the group.
0:39:47 > 0:39:49Basso's scheme was being brutally executed.
0:39:51 > 0:39:55The daily physical and mental abuse continued until, one day,
0:39:55 > 0:39:57after a sustained attack,
0:39:57 > 0:40:00Buddy's body couldn't take any more
0:40:00 > 0:40:02and he died from a fractured skull.
0:40:06 > 0:40:09His unrecognisable body was dumped
0:40:09 > 0:40:11in a ditch on the outskirts of town...
0:40:12 > 0:40:13..and discovered days later.
0:40:16 > 0:40:18After disposing of the body,
0:40:18 > 0:40:22Basso called Buddy's friends and family claiming he'd gone missing.
0:40:23 > 0:40:26She even called the police and filed a missing person's report.
0:40:28 > 0:40:32It was this phone call that led police straight to her doorstep.
0:40:33 > 0:40:37Basso and her son, James, were asked to identify Buddy's body.
0:40:38 > 0:40:42James confirmed it was him with a glance from over 20 yards away.
0:40:44 > 0:40:47Which gave detectives serious cause for concern.
0:40:50 > 0:40:53Basso and her son were taken in for questioning.
0:40:53 > 0:40:56When James was asked how he identified Buddy without
0:40:56 > 0:41:00proper view of the body, he unexpectedly confessed all.
0:41:03 > 0:41:07The rest of Buddy's tormentors were rounded up and arrested.
0:41:07 > 0:41:09One by one, they confessed.
0:41:09 > 0:41:13But tried to pin the blame for his actual murder onto each other.
0:41:15 > 0:41:19However, they were consistent on who masterminded the whole plot.
0:41:19 > 0:41:22His supposed girlfriend, Suzanne Basso.
0:41:23 > 0:41:26When interviewed, Basso confessed to befriending Buddy
0:41:26 > 0:41:28with the intent to defraud him...
0:41:29 > 0:41:33..and admitted to the ritualistic torture she had instructed upon him.
0:41:36 > 0:41:39Suzanne Basso, along with her son and accomplices,
0:41:39 > 0:41:42were charged with Buddy's murder.
0:41:45 > 0:41:48At trial, despite the overwhelming evidence,
0:41:48 > 0:41:49she entered a not guilty plea.
0:41:50 > 0:41:53Her co-defendants gave evidence against her.
0:41:54 > 0:41:58But the most compelling testimony would come from the medical examiner
0:41:58 > 0:41:59who detailed Buddy's injuries.
0:42:01 > 0:42:03They ranged from 14 broken ribs,
0:42:03 > 0:42:0628 cigarette burns on his back,
0:42:06 > 0:42:08to the head injury that eventually killed him.
0:42:10 > 0:42:14The jury found Suzanne Basso guilty of capital murder
0:42:14 > 0:42:18and for attempting to profit from insurance proceeds.
0:42:18 > 0:42:20She could've spent the rest of her life in jail.
0:42:20 > 0:42:24But as this was in Texas, where the death penalty is legal,
0:42:24 > 0:42:26she was sentenced to death.
0:42:29 > 0:42:34Suzanne Basso was executed by lethal injection in 2014.
0:42:34 > 0:42:37Her son, James, and the five other accomplices were convicted
0:42:37 > 0:42:40for the part they played in Buddy's torturous murder
0:42:40 > 0:42:42and remain in prison.
0:42:45 > 0:42:47Buddy was a kind, gentle soul.
0:42:48 > 0:42:52Basso manipulated and murdered him to cash in by fraudulently
0:42:52 > 0:42:55claiming his life insurance.
0:43:01 > 0:43:05From organised criminal gangs to exaggerated household claims,
0:43:05 > 0:43:08insurance fraud hits all of us in the pocket.
0:43:08 > 0:43:09But instead of getting away with it,
0:43:09 > 0:43:13more and more of these fraudsters are being claimed and shamed.