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 > 0:00:23Deliberate crashes, bogus personal injuries, even phantom pets.
0:00:25 > 0:00:29The fraudsters are risking more and more to make a quick killing and
0:00:29 > 0:00:34every year it's adding around £50 to your insurance bill.
0:00:34 > 0:00:36But insurers are fighting back,
0:00:36 > 0:00:39exposing just under 15 fake claims every hour.
0:00:39 > 0:00:41Armed with covert surveillance systems...
0:00:41 > 0:00:44Subject out of the vehicle.
0:00:44 > 0:00:46..sophisticated data analysis techniques...
0:00:48 > 0:00:52- ..and a number of highly-skilled police units...- Police, don't move.
0:00:52 > 0:00:55- Stay where- you are! ..they are catching the criminals red-handed.
0:00:55 > 0:00:57Just don't lie to us!
0:00:58 > 0:01:00All those conmen, scammers and
0:01:00 > 0:01:04cheats on the fiddle are now caught in the act and Claimed And Shamed.
0:01:09 > 0:01:15Today, a group of friends that deliberately crash their cars for money are exposed.
0:01:15 > 0:01:18It quickly became apparent that she had lied to us when she told
0:01:18 > 0:01:20us that she did not know the other driver.
0:01:20 > 0:01:25A claimant's attempt to dupe a new device from her phone insurers is blocked.
0:01:31 > 0:01:34And something stinks when a high-end men's tailor claims his stock is
0:01:34 > 0:01:37spoilt by sewage.
0:01:37 > 0:01:42It became apparent that some of this documentation had, in fact, been
0:01:42 > 0:01:44created by Mr L on his own computer.
0:01:49 > 0:01:53More than 35 million of us get behind the wheel in the UK.
0:01:53 > 0:01:57That adds up to a huge number of car policies and a staggering
0:01:57 > 0:02:02£17.1 million is paid out in private car claims every day.
0:02:02 > 0:02:06Statistics like that can be appetising for fraudsters and opportunists alike.
0:02:06 > 0:02:10So, insurance companies are fighting a constant battle to identify
0:02:10 > 0:02:12the genuine claims from those that have been exaggerated,
0:02:12 > 0:02:19completely made up, or have even been the result of deliberate crashes.
0:02:19 > 0:02:23The UK highways are some of the busiest in the world, with motorists
0:02:23 > 0:02:28clocking-up an estimated 314 billion miles every year.
0:02:31 > 0:02:34Mark Chiappino, at Direct Line Group,
0:02:34 > 0:02:39has made it his business to bust the claims of fraudsters.
0:02:39 > 0:02:44He was passed what looked like a fairly typical rear-end shunt accident to review.
0:02:44 > 0:02:46Our customer, Ffion Owen,
0:02:46 > 0:02:48notified us that she had had an accident,
0:02:48 > 0:02:51driving her Ford Focus into the rear of an Audi A4,
0:02:51 > 0:02:53driven by Faizal Saidi.
0:02:53 > 0:02:56This accident occurred on a residential street in Liverpool.
0:02:56 > 0:02:59On the face of it, this appeared to be a genuine accident.
0:02:59 > 0:03:02This is the type of accident that happens hundreds, if not thousands,
0:03:02 > 0:03:04of times every day on British roads.
0:03:04 > 0:03:07It may have been an everyday occurrence,
0:03:07 > 0:03:09but the timing was a little convenient
0:03:09 > 0:03:13as Owen, who had rear-ended Saidi's car,
0:03:13 > 0:03:18only had a week before her policy was due to expire.
0:03:18 > 0:03:22We were subsequently notified of eight personal injury claims from
0:03:22 > 0:03:26the occupants of the Audi and from Ffion Owen's own passengers.
0:03:26 > 0:03:29These claims totalled approximately £38,000.
0:03:29 > 0:03:32With only a week left on her policy and a high number of personal injury
0:03:32 > 0:03:36claims submitted, suspicions were raised,
0:03:36 > 0:03:39which led investigators to probe a little deeper.
0:03:39 > 0:03:42We asked her, as a matter of routine whether she knew any of the occupants of
0:03:42 > 0:03:44the other vehicles and she said that she didn't.
0:03:44 > 0:03:46When the injury claims were presented,
0:03:46 > 0:03:48we carried out further routine searches.
0:03:48 > 0:03:51Our enquiries via social media led us to discover that not only did
0:03:51 > 0:03:54Ffion Owen know Faizal Saidi,
0:03:54 > 0:03:57but that she also featured in several photographs of the two of them together.
0:03:57 > 0:04:02So, they had been proven to have exchanged more than paintwork previously.
0:04:02 > 0:04:04It was damning evidence.
0:04:04 > 0:04:07It quickly became apparent that she had lied to us when she told us that
0:04:07 > 0:04:09she did not know the other driver.
0:04:09 > 0:04:12Having been on the end of a barefaced lie,
0:04:12 > 0:04:15Mark's team were keen to separate fact from fiction.
0:04:15 > 0:04:19We started investigating this accident as a suspicious claim.
0:04:19 > 0:04:22We instructed a forensic engineer to examine both vehicles and gather
0:04:22 > 0:04:24further evidence.
0:04:24 > 0:04:28And it would reveal some very curious discoveries.
0:04:28 > 0:04:31The claim was presented to us as if Ffion Owen had driven into the back
0:04:31 > 0:04:34of the Audi. When the Audi was examined,
0:04:34 > 0:04:38we found damage on both the rear wings and on the rear of the vehicle.
0:04:40 > 0:04:42This is damage that defies the law of physics.
0:04:42 > 0:04:44The clue is in the title.
0:04:44 > 0:04:46Rear-end shunt.
0:04:47 > 0:04:49But those laws of physics continued to be broken.
0:04:49 > 0:04:52There were screw heads protruding from one of the vehicles.
0:04:52 > 0:04:54If there had been a single accident,
0:04:54 > 0:04:58you would expect to find one corresponding mark on the other
0:04:58 > 0:05:03damaged vehicle. However, he found not one, not two, not even three,
0:05:03 > 0:05:07but four corresponding marks on the other vehicle,
0:05:07 > 0:05:11indicating that the vehicles had been collided at least four times.
0:05:11 > 0:05:15Yeah, you don't have to be a forensic engineer to figure out that
0:05:15 > 0:05:18Owen's story was no longer adding up.
0:05:18 > 0:05:23Once we realised that a serious attempt had been made to defraud Direct Line of £38,000,
0:05:23 > 0:05:25we passed the details immediately to
0:05:25 > 0:05:28the police insurance fraud enforcement department at Ifed.
0:05:28 > 0:05:32Ifed snapped up the case and were eager to build on the investigative work
0:05:32 > 0:05:34Direct Line had already done.
0:05:34 > 0:05:37There was already quite a lot of evidence there.
0:05:37 > 0:05:40The circumstances were broadly quite suspicious.
0:05:40 > 0:05:42If these cars had genuinely crashed together,
0:05:42 > 0:05:44there would only be one impact.
0:05:44 > 0:05:47And also there shouldn't really be any kind of links between the
0:05:47 > 0:05:49occupants of either vehicle.
0:05:49 > 0:05:51With the connection between the drivers of
0:05:51 > 0:05:53both vehicles established,
0:05:53 > 0:05:57Oliver had to identify and move in on any other suspects.
0:05:57 > 0:06:00When we looked at all the information we had about this case,
0:06:00 > 0:06:04the most important thing for us was to focus down on
0:06:04 > 0:06:08the key orchestrators. So, Faizal Saidi was driving one vehicle.
0:06:08 > 0:06:11The other vehicle was being driven by Ffion Owen.
0:06:11 > 0:06:15But we also wanted to speak to her boyfriend, Ciaran Hodson,
0:06:15 > 0:06:18because we believed that there was evidence that he was the link
0:06:18 > 0:06:25- between the two.- Hodson was also a passenger in Owen's car at the time of the accident.
0:06:25 > 0:06:30It was time for Ifed to take this investigation to the next level.
0:06:30 > 0:06:34We went to go and arrest Mr Hodson at his home address.
0:06:34 > 0:06:37When we investigate crash-for-cash cases,
0:06:37 > 0:06:39we're typically looking for anything...
0:06:39 > 0:06:42Any kind of paperwork that relates to the insurance claim.
0:06:42 > 0:06:44Also, we're often looking for phones because they can tell us a huge
0:06:44 > 0:06:47amount about who's been in contact with who,
0:06:47 > 0:06:50and crucially when. And if it's before the date of a collision,
0:06:50 > 0:06:53then that's often telling evidence.
0:06:53 > 0:06:57We came away with quite a lot of paperwork and some phones from his address.
0:06:57 > 0:07:00The phones clearly showed frequent communication before
0:07:00 > 0:07:04the accident between Owen, Hodson and the driver of the other car,
0:07:04 > 0:07:06Faizal Saidi.
0:07:06 > 0:07:08In light of the evidence,
0:07:08 > 0:07:12this Bonnie and Clyde duo didn't last long under interview.
0:07:14 > 0:07:17Fairly unusually for a crash-for-cash investigation,
0:07:17 > 0:07:21both Hodson and Owen fully admitted that this collision had never really
0:07:21 > 0:07:25happened, as they tried to purport to the insurance companies,
0:07:25 > 0:07:28that they'd crashed the cars together to make some money.
0:07:28 > 0:07:32And also because one of the vehicles already had a broken bumper and they
0:07:32 > 0:07:35wanted to get a cheap repair.
0:07:35 > 0:07:40With Owen and Hudson telling all, it was two suspects down, one to go.
0:07:40 > 0:07:43We found Mr Saidi harder to locate.
0:07:43 > 0:07:46More difficult to find and get his account.
0:07:46 > 0:07:49Luckily, some colleagues of ours in a separate police force were also
0:07:49 > 0:07:53looking to speak to Mr Saidi and so we were able to coordinate our
0:07:53 > 0:07:55efforts and track him down.
0:07:55 > 0:07:58So, Saidi was a man in demand.
0:07:58 > 0:08:00But once Ifed had him in custody,
0:08:00 > 0:08:04he wasn't as forthcoming as his partners in crime.
0:08:04 > 0:08:06Mr Saidi didn't want to answer any of our questions.
0:08:06 > 0:08:08But by that stage, we had his phone.
0:08:08 > 0:08:12And so we had plenty of evidence there to show that there had been an
0:08:12 > 0:08:17exchange between Mr Hodson and Mr Saidi of the details of Ms Owen's
0:08:17 > 0:08:19vehicle and bank account details.
0:08:19 > 0:08:22All leading up to the accident date.
0:08:22 > 0:08:26So, we had clear evidence that this was a relatively carefully planned
0:08:26 > 0:08:29and orchestrated crash-for-cash scam.
0:08:29 > 0:08:33That was the final nail in the coffin for our troublesome trio.
0:08:35 > 0:08:39The outcome was that we had compiled a pretty overwhelming case and we
0:08:39 > 0:08:43took that to the Crown Prosecution Service who authorised charges against
0:08:43 > 0:08:48all of these people. And we took them to court and they were all convicted.
0:08:48 > 0:08:51Having pled guilty to fraud by false representation,
0:08:51 > 0:08:54all three were sentenced to 12 months' imprisonment,
0:08:54 > 0:08:56suspended for two years,
0:08:56 > 0:08:59and were each ordered to pay back £3,000 to Direct Line.
0:08:59 > 0:09:03I think what this case highlights is there's a multitude of ways that
0:09:03 > 0:09:06insurers and the police look at crash-for-cash.
0:09:06 > 0:09:11I think it's fair to say that the days of easy whiplash claims and
0:09:11 > 0:09:13quick cash from crashes have gone.
0:09:13 > 0:09:17There's a huge amount of work being done by the industry and the police
0:09:17 > 0:09:19and it's only ever going to get harder.
0:09:25 > 0:09:29Later, the owner of a puppy lies about it's date of death, to obtain
0:09:29 > 0:09:31false insurance cover.
0:09:36 > 0:09:40And a driver's claim his car was sideswiped by a bus breaks down when
0:09:40 > 0:09:43CCTV shows it barely left a scratch.
0:09:43 > 0:09:45Take a look at that.
0:09:45 > 0:09:47The car doesn't even move.
0:09:51 > 0:09:54Now, for most of us, living without our smartphones or tablets just
0:09:54 > 0:09:58isn't an option. Whether you're keeping in touch, working on the go,
0:09:58 > 0:10:00sharing your life with the world,
0:10:00 > 0:10:04or are an online Scrabble addict like me.
0:10:04 > 0:10:07Yeah! The modern day smartphone lets you do it all.
0:10:07 > 0:10:11So, when we lose or break them, it's a big deal.
0:10:11 > 0:10:15And that's why we have mobile phone insurance.
0:10:15 > 0:10:18Luckily, mobile insurers can reconnect us with a replacement handset and
0:10:18 > 0:10:22have us selfieing again before we know it.
0:10:22 > 0:10:26But this service has also been targeted by fraudsters who think
0:10:26 > 0:10:29they can make some easy money.
0:10:29 > 0:10:34In the event of a device disaster, Andy Morris's team are on hand to help.
0:10:34 > 0:10:37All manner of claims come across Andy's desk.
0:10:37 > 0:10:40One particular case he was given to review, presented like a fairly
0:10:40 > 0:10:44standard phone faux pas.
0:10:44 > 0:10:49So, this lady called our claims team and told us that her iPhone had been
0:10:49 > 0:10:54damaged and said that they had dropped the phone on the road and
0:10:54 > 0:10:58the phone had been run over by various vehicles.
0:11:27 > 0:11:32It's not hugely unusual for our customers to drop their phone and
0:11:32 > 0:11:35subsequently a vehicle go over the phone.
0:11:35 > 0:11:40It's quite rare that a phone would be run over by numerous vehicles.
0:11:40 > 0:11:44Indeed, and the claimant explained how her handset was well beyond saving.
0:11:44 > 0:11:49So, at that point, a claims agent offered to swap or repair the
0:11:49 > 0:11:52device for the customer.
0:11:52 > 0:11:57To which they were told quite clearly the phone was in several pieces.
0:11:57 > 0:12:04And what's more, the claimant didn't have time to swap the device.
0:12:04 > 0:12:06Despite a rather smashing story,
0:12:06 > 0:12:10there was no way to validate the claimant's account of what had happened.
0:12:10 > 0:12:15But the claims handler was still prepared to give her the benefit of the doubt.
0:12:15 > 0:12:19So, we gave her the opportunity of claiming for a brand-new handset,
0:12:19 > 0:12:23which we would call a replacement loss.
0:12:23 > 0:12:27We asked for some additional information to process the claim.
0:12:27 > 0:12:30In a normal set of circumstances,
0:12:30 > 0:12:34that information would be processed on the same claim,
0:12:34 > 0:12:37or within minutes or hours.
0:12:37 > 0:12:40Well, this wasn't a normal situation.
0:12:40 > 0:12:42And things took slightly longer than that.
0:12:42 > 0:12:48We heard nothing from this claimant for ten months.
0:12:48 > 0:12:54It's incredibly unusual for there to be such a long gap.
0:12:54 > 0:12:59To be without the handset is equivalent
0:12:59 > 0:13:02to losing an arm or a hand.
0:13:02 > 0:13:06That's a wait of nearly a year to complete the claim for her destroyed device.
0:13:06 > 0:13:09While the claimant was in no rush,
0:13:09 > 0:13:13Andy's team had plenty of time to look into her phoney story.
0:13:13 > 0:13:17Whilst processing the claim and gathering the information and the
0:13:17 > 0:13:19evidence, our claims handling agent
0:13:19 > 0:13:23found evidence that this unique device
0:13:23 > 0:13:28had been exchanged directly with a manufacturer before the original
0:13:28 > 0:13:32claim had been notified to us.
0:13:32 > 0:13:36Andy's team had proof that the claimant had exchanged the phone
0:13:36 > 0:13:39reported to be damaged, some ten months ago
0:13:39 > 0:13:42and had already received a replacement handset.
0:13:42 > 0:13:45This information was put to her.
0:14:23 > 0:14:25The claimant might well be on the back foot.
0:14:25 > 0:14:28Andy's team have established that the allegedly smashed device was
0:14:28 > 0:14:31exchanged for a brand-new one ten months ago
0:14:31 > 0:14:34courtesy of the phone manufacturer.
0:14:34 > 0:14:39As her phone number would have transferred over to any new phone she was given,
0:14:39 > 0:14:44Assurant could see she had been using the replacement handset all along.
0:14:44 > 0:14:48Quite clearly in this case, the claimant stood to profit
0:14:48 > 0:14:51because she had already
0:14:51 > 0:14:57replaced the phone and she was then subsequently claiming for a new phone.
0:14:57 > 0:15:02So, she would have profited because the result would have been two devices.
0:15:02 > 0:15:04Even faced with the evidence,
0:15:04 > 0:15:06the claimant was determined to play dumb.
0:15:28 > 0:15:32During the claims process, our agent gathered the evidence
0:15:32 > 0:15:35not only that this handset had been exchanged,
0:15:35 > 0:15:42but also the mobile phone number and the individual claimant's
0:15:42 > 0:15:45information was exactly the same.
0:15:45 > 0:15:48In short, the evidence suggested the claimant was trying to claim for
0:15:48 > 0:15:52a phone that had already been replaced.
0:15:52 > 0:15:55But the curious gap of ten months before she even attempted to claim
0:15:55 > 0:15:58with her insurers, gave Assurant cause for concern,
0:15:58 > 0:16:04as well as time to investigate, allowing them to uncover key information.
0:16:04 > 0:16:06At this stage,
0:16:06 > 0:16:11the evidence that we'd gathered during the claims process made it
0:16:11 > 0:16:14pretty unequivocal that the original story
0:16:14 > 0:16:16that the handset had been dropped in
0:16:16 > 0:16:22the road and run over by various vehicles actually had no fact.
0:16:22 > 0:16:26But there was no budging the claimant from her version of events.
0:16:49 > 0:16:52We had evidence to prove that the handset had been swapped.
0:16:52 > 0:16:54So, during the call,
0:16:54 > 0:16:59on supplying the information and the evidence to this claimant,
0:16:59 > 0:17:03the lady merely said, "OK, all right, thanks."
0:17:19 > 0:17:24And just like that, the ongoing 10-month claim was over.
0:17:24 > 0:17:27The claimant's willingness to throw in the towel, strongly suggests she
0:17:27 > 0:17:32thought pulling a fast one would be easy as one, two, three.
0:17:32 > 0:17:36What's incredible about this case is the behaviour of the claimant.
0:17:36 > 0:17:42They probably don't realise that every conversation, or every interaction,
0:17:42 > 0:17:46is recorded. So, what that means is our ability to detect fraud,
0:17:46 > 0:17:50even though it might be ten months later, is greater.
0:17:56 > 0:17:59Now, you probably have never wondered what an insurance cheat looks like,
0:17:59 > 0:18:02but I can tell you they come in many guises from all manner of
0:18:02 > 0:18:04backgrounds. The truth is,
0:18:04 > 0:18:06not all fraud is committed by what you might consider
0:18:06 > 0:18:08out-and-out criminals. In fact,
0:18:08 > 0:18:14there are often individuals in respected positions who have no history of criminality,
0:18:14 > 0:18:17but for whatever reason decide to go down a dishonest path.
0:18:19 > 0:18:23RSA's John Beadle picked up the thread of a case which needed some
0:18:23 > 0:18:26further investigation, back in 2009.
0:18:26 > 0:18:31This was a claim from a gentleman who had been a loyal customer of
0:18:31 > 0:18:36ours for some time, in respect of his commercial property,
0:18:36 > 0:18:40which was a rather exclusive Central London menswear shop.
0:18:40 > 0:18:45And he made a claim in respect of water damage
0:18:45 > 0:18:47caused at his commercial premises,
0:18:47 > 0:18:51which had damaged both his stock and
0:18:51 > 0:18:53his personal clothing.
0:18:53 > 0:18:56On the face of it, this was a genuine claim,
0:18:56 > 0:19:02which we settled relatively quickly with a cash payment of £30,000.
0:19:02 > 0:19:08But unfortunately, the claimant's bad luck soon struck again.
0:19:08 > 0:19:14Some years later, Mr Elle made another claim where sewage had escaped into
0:19:14 > 0:19:20his commercial premises and had damaged again both his
0:19:20 > 0:19:23commercial stock and also his personal effects.
0:19:23 > 0:19:27The value of this claim was some £39,000.
0:19:27 > 0:19:30With Mr Elle's high-end suits ruined and reeking,
0:19:30 > 0:19:34the conditions of the claim were also a little whiffy.
0:19:34 > 0:19:39This being the second occasion with very similar circumstances,
0:19:39 > 0:19:45it would prompt us to look a little closer, which is indeed what we did.
0:19:45 > 0:19:48John's team were determined to wring out the truth.
0:19:48 > 0:19:53We asked Mr Elle to substantiate the claim and give us a list of the items
0:19:53 > 0:19:55which had been damaged and these
0:19:55 > 0:20:00were really expensive pieces of clothing.
0:20:00 > 0:20:05He produced to us some documentation to support his claim.
0:20:05 > 0:20:07When we examined this,
0:20:07 > 0:20:13we found actually it bared very similar relationship with the original claim.
0:20:13 > 0:20:15Whilst not quite a duplicate of it,
0:20:15 > 0:20:18it appeared to contain items which were the same.
0:20:18 > 0:20:20Highly suspicious that the two
0:20:20 > 0:20:23claims bore such startling similarities,
0:20:23 > 0:20:28the paperwork Mr Elle had supplied was analysed for any discrepancies.
0:20:28 > 0:20:31It became apparent that some of this documentation had in fact been
0:20:31 > 0:20:35created by Mr Elle on his own computer
0:20:35 > 0:20:38the day before the visit by our
0:20:38 > 0:20:42investigator and no doubt in preparation for his visit.
0:20:42 > 0:20:46With strong evidence that Mr Elle had submitted a fraudulent claim,
0:20:46 > 0:20:50it was time to air his dirty laundry in public.
0:20:50 > 0:20:54We confronted Mr Elle with our difficulties
0:20:54 > 0:20:57we had in respect of the claim
0:20:57 > 0:20:59and the supporting documentation
0:20:59 > 0:21:04and he offered no reasonable explanation.
0:21:04 > 0:21:08We certainly weren't going to pay the claim and in fact we referred
0:21:08 > 0:21:11the case to Ifed.
0:21:11 > 0:21:14The Insurance Fraud Enforcement Department took the case on
0:21:14 > 0:21:17and after reviewing the evidence and interviewing Mr Elle,
0:21:17 > 0:21:21it wouldn't be long before he would need one of his own suits for
0:21:21 > 0:21:23a very formal occasion.
0:21:23 > 0:21:29Ifed picked up our investigation and ultimately charged Mr Elle
0:21:29 > 0:21:32with two counts of fraud.
0:21:32 > 0:21:34He went to crown court,
0:21:34 > 0:21:37where he pleaded guilty and he was sentenced to
0:21:37 > 0:21:41ten months' imprisonment, suspended for 12 months,
0:21:41 > 0:21:47and ordered to do 160 hours of community work.
0:21:47 > 0:21:50Mr Elle had narrowly escaped a custodial sentence.
0:21:50 > 0:21:53But RSA still had unfinished business with him.
0:21:53 > 0:21:57In addition to the prison sentence and the conviction that
0:21:57 > 0:21:59Mr Elle received,
0:21:59 > 0:22:05we will be pursuing recovery of our own original payment of £30,000.
0:22:05 > 0:22:08This well-respected fashion entrepreneur and businessmen had
0:22:08 > 0:22:11paid a high price for his attempted fraud.
0:22:11 > 0:22:14I think when Mr Elle reflects on this,
0:22:14 > 0:22:18he will obviously bitterly regret his actions.
0:22:18 > 0:22:22And the shame that he's brought on himself,
0:22:22 > 0:22:26his family and indeed his respected business.
0:22:31 > 0:22:34Still to come, a fisherman is caught hook,
0:22:34 > 0:22:36line and sinker after faking a burglary.
0:22:36 > 0:22:40We challenged the customer over that and he admitted that the item
0:22:40 > 0:22:43actually in the photograph wasn't stolen.
0:22:47 > 0:22:50Whether you've got a soft spot for cute kitties or a love for
0:22:50 > 0:22:55pedigree dogs, pet insurance offers owners protection should their furry friends
0:22:55 > 0:22:59need help. It's one of those policies you hope you'll never need,
0:22:59 > 0:23:02but it's also one that's all too easy to let slip.
0:23:02 > 0:23:04Unfortunately, there are some owners out there who,
0:23:04 > 0:23:08in the event they find themselves without valid cover,
0:23:08 > 0:23:13will do almost anything to get their hands on a pay-out.
0:23:13 > 0:23:15Puppies are adorable.
0:23:15 > 0:23:18But these cute canines are a huge responsibility and incredibly
0:23:18 > 0:23:23vulnerable. So, when a dog owner called to report a tragic accident,
0:23:23 > 0:23:28Simon Wheeler's team were on hand to deal with the call.
0:23:28 > 0:23:31This claim concerns a very young Pomeranian puppy.
0:23:31 > 0:23:33A very, very sad case.
0:23:33 > 0:23:35The owners were moving house.
0:23:35 > 0:23:37In the evening, sadly,
0:23:37 > 0:23:41the policyholder's sister trod on the puppy and killed it.
0:23:41 > 0:23:43A horrible accident.
0:23:43 > 0:23:47The claimant had bought the puppy from a breeder and he'd come with
0:23:47 > 0:23:50a free 28-day period of insurance cover.
0:23:50 > 0:23:55The first time we heard from the policyholder was a telephone call
0:23:55 > 0:23:58just to determine when the temporary period of insurance ran out.
0:23:58 > 0:24:02So, she'd elected not to continue that into a full annual policy.
0:24:02 > 0:24:05So, the date was obviously important to her,
0:24:05 > 0:24:09in terms of when the accident happened.
0:24:09 > 0:24:11The purchase price of the puppy was £1,500.
0:24:11 > 0:24:13A sizeable sum.
0:24:13 > 0:24:15And without a valid policy,
0:24:15 > 0:24:17the claimant wouldn't receive a penny back.
0:24:34 > 0:24:37And it wouldn't be long before the claims team would hear from her again.
0:24:37 > 0:24:39That very same day,
0:24:39 > 0:24:42we then had another conversation with the policyholder.
0:24:42 > 0:24:46And she called up to advise us that the puppy had died.
0:24:59 > 0:25:04The 15th. Just one day before the policy was due to expire.
0:25:04 > 0:25:09A fact she had suspiciously checked just hours earlier.
0:25:09 > 0:25:12The claimant appeared to be too distraught to continue the call
0:25:12 > 0:25:14and passed the phone to her daughter.
0:25:44 > 0:25:47Between the claimant and her daughter,
0:25:47 > 0:25:52we have established that the puppy died the day they were moving house.
0:25:52 > 0:25:54But examining the veterinary records
0:25:54 > 0:25:57gave Simon's team serious cause for concern.
0:25:57 > 0:26:00I'm looking at the veterinary history,
0:26:00 > 0:26:05the date that the puppy was killed was actually different to the date
0:26:05 > 0:26:08the policyholder had suggested.
0:26:08 > 0:26:10Rather than the 15th of December,
0:26:10 > 0:26:12with the policy expiring on the 16th,
0:26:12 > 0:26:16the date that the vet had recorded was actually the 17th.
0:26:16 > 0:26:19So, the claim wasn't covered.
0:26:19 > 0:26:22With the claimant's cover expiring on the 16th,
0:26:22 > 0:26:24this information was put to her.
0:26:44 > 0:26:45So, once again,
0:26:45 > 0:26:49it seemed to be the claimant's daughter who was in charge of dealing with
0:26:49 > 0:26:50the puppy's untimely death.
0:26:50 > 0:26:53The policyholder received the notice from us that we declined
0:26:53 > 0:26:58the claim because the incident occurred outside the period of cover,
0:26:58 > 0:27:00as detailed in the veterinary notes.
0:27:00 > 0:27:04The policyholder then challenged the veterinary history.
0:27:04 > 0:27:06Despite the contradicting evidence,
0:27:06 > 0:27:08the claimant was sticking to her story.
0:27:32 > 0:27:35She's now blaming the discrepancy on her daughter's error.
0:27:35 > 0:27:38And despite the claimant's increasing irritation,
0:27:38 > 0:27:41the claims handler calmly relays the facts.
0:28:00 > 0:28:03The claimant was starting to make a real dog's dinner of her story.
0:28:03 > 0:28:06Furthermore, on listening to the calls,
0:28:06 > 0:28:09the policyholder had been insistent that the puppy had been trodden on
0:28:09 > 0:28:11on the day that they moved house.
0:28:11 > 0:28:13And that date was the 15th of December.
0:28:13 > 0:28:15When we went back to the policyholder
0:28:15 > 0:28:17after we'd done our investigations,
0:28:17 > 0:28:20she confirmed that actually the date of moving was the 17th
0:28:20 > 0:28:22and the puppy had been killed on the 17th.
0:28:37 > 0:28:39CLAIMANT SIGHS
0:28:39 > 0:28:44A telling sigh. The claimant has just dropped herself right in it.
0:28:44 > 0:28:48The policy expired on the 16th of December and we've already
0:28:48 > 0:28:52established that the puppy's death and their house move occurred on the same day,
0:28:52 > 0:28:55which she's just admitted to being the 17th of December.
0:28:55 > 0:28:59Crucially, a day after the cover had ended.
0:28:59 > 0:29:01Having had a situation where
0:29:01 > 0:29:04the policyholder had tried to move the date,
0:29:04 > 0:29:06to bring the date into the period of cover,
0:29:06 > 0:29:09to have the purchase price covered,
0:29:09 > 0:29:12it was yet more of an indication that she was trying to twist and
0:29:12 > 0:29:16manipulate the cover to suit her needs.
0:29:16 > 0:29:21Despite this whole dispute centring around when the puppy had his fatal
0:29:21 > 0:29:25accident, the claimant decides that dates are suddenly unimportant.
0:29:39 > 0:29:41Again, she was trying to manipulate
0:29:41 > 0:29:45the timing of the puppy's death to fall inside the period of cover.
0:29:45 > 0:29:48So, she's insistent and desperate and nothing was too much effort for her.
0:29:48 > 0:29:51The claimant is clearly frustrated,
0:29:51 > 0:29:55but the simple fact is her policy expired on the 16th of December and
0:29:55 > 0:29:58she did not have valid cover.
0:29:58 > 0:30:00But she's refusing to back down.
0:30:33 > 0:30:35While the claimant continued to pass the buck,
0:30:35 > 0:30:38the evidence was overwhelming.
0:30:38 > 0:30:42The rejection of the claim stood and no money was paid out,
0:30:42 > 0:30:45although this type of lengthy investigation
0:30:45 > 0:30:46still does cost insurers.
0:30:46 > 0:30:51It's tedious and it's time-consuming for all parties.
0:30:51 > 0:30:56That adds a huge administrative burden into the process for us.
0:30:56 > 0:30:58That administrative burden comes with a cost.
0:30:58 > 0:31:01That cost, unfortunately, gets loaded into premiums.
0:31:01 > 0:31:05This case proves that anyone who tries to pull one over on pet insurers is
0:31:05 > 0:31:08going to have a rough day.
0:31:08 > 0:31:11For people who try to manipulate dates or adjust things to suit their
0:31:11 > 0:31:15own ends, it's usually very easy to see through it.
0:31:15 > 0:31:18It doesn't take much effort to really pick under the skin of
0:31:18 > 0:31:22situations that don't appear to be as they should be.
0:31:27 > 0:31:30When it comes to making an insurance claim, there's no such thing as a
0:31:30 > 0:31:32little white lie.
0:31:32 > 0:31:36If you've been involved in a genuine accident, then exaggerating or
0:31:36 > 0:31:40fabricating any damages and injuries to get a bigger pay-out is fraud.
0:31:40 > 0:31:44And it can land those who try it in very hot water.
0:31:44 > 0:31:47Transport companies are often victim to this type of opportunistic fraud
0:31:47 > 0:31:51as there's a misconception they're a soft touch.
0:31:51 > 0:31:56But this couldn't be further from the truth.
0:31:56 > 0:31:59There are thousands of buses operating on UK roads.
0:31:59 > 0:32:02These mechanical beasts are hard to miss.
0:32:02 > 0:32:05Sometimes, literally.
0:32:05 > 0:32:08Lee Ingram knows all about how motorists can get tangled up with
0:32:08 > 0:32:10these oversize vehicles.
0:32:10 > 0:32:14He was asked to look over one claim which seemed to be at the minor end
0:32:14 > 0:32:16of the accident scale.
0:32:16 > 0:32:19The actual accident circumstances in this case were
0:32:19 > 0:32:22that a bus was overtaking a stationary line of traffic on its right.
0:32:22 > 0:32:26It's gone ahead to do a left-hand turn into a side road and as it's done so,
0:32:26 > 0:32:31the rear tail of the bus has swung out and pressed up against
0:32:31 > 0:32:35the stationary car. The bus driver didn't actually know an incident had occurred.
0:32:35 > 0:32:37It wasn't until a short while after,
0:32:37 > 0:32:40when the car driver followed him down the road
0:32:40 > 0:32:43and let him know that the accident happened, that he was aware of it.
0:32:43 > 0:32:46A seemingly minor accident,
0:32:46 > 0:32:49but the occupants of the car submitted damages and personal injury claims
0:32:49 > 0:32:52totalling over £8,000,
0:32:52 > 0:32:56which prompted Lee's team to re-examine the circumstances of the incident.
0:32:56 > 0:33:00When we reviewed the accounts given by both of the claimants,
0:33:00 > 0:33:03we found a number of inconsistencies in their statements.
0:33:03 > 0:33:07Both of the claimants in this incident are alleging that they were jolted forwards
0:33:07 > 0:33:12and backwards in their vehicle when the collision has occurred.
0:33:12 > 0:33:14One of them's claiming that they were moving at a slow speed.
0:33:14 > 0:33:17The other one said that they were moving at a moderate speed.
0:33:17 > 0:33:20But the key factor there is that they both allege that the vehicle
0:33:20 > 0:33:24was moving at the time that the bus struck them.
0:33:24 > 0:33:26A strange account,
0:33:26 > 0:33:31as the initial report had stated that the car was stationary during the incident.
0:33:31 > 0:33:34But it would be the personal injury claims that would raise serious
0:33:34 > 0:33:37- suspicions.- The driver of the car has submitted a claim for
0:33:37 > 0:33:41soft tissue injuries to his neck and back.
0:33:41 > 0:33:45He's also alleging that he's got a fear of travel after this
0:33:45 > 0:33:47seemingly low-speed impact.
0:33:47 > 0:33:51He's also put in a claim for care and domestic assistance.
0:33:51 > 0:33:55So, cooking, cleaning, childcare.
0:33:55 > 0:33:58We do see these claims from time to time and the key really is to look
0:33:58 > 0:34:01at the injuries sustained and think, "Is that reasonable?"
0:34:01 > 0:34:04But you're also looking, in this case, to see who has actually
0:34:04 > 0:34:06provided that care.
0:34:06 > 0:34:09Given the extent of the claimant's alleged injuries and
0:34:09 > 0:34:11the psychological effect of the accident,
0:34:11 > 0:34:15you'd suspect a team of highly trained medical experts, wouldn't you?
0:34:15 > 0:34:20He's alleging that the person who's given this care was his wife.
0:34:20 > 0:34:25Now, she submitted in her claim that she also cannot do these very things
0:34:25 > 0:34:28that he's alleging she assisted him with.
0:34:28 > 0:34:32These two clearly need to communicate more often.
0:34:32 > 0:34:35Sounds like the blind leading the blind.
0:34:35 > 0:34:37And it wasn't just the claimant's personal injuries
0:34:37 > 0:34:40Lee suspected were hugely exaggerated.
0:34:40 > 0:34:45After an accident, we will often inspect a vehicle involved in a collision with one of our buses.
0:34:45 > 0:34:49Part of that inspection is to take photos of the vehicle.
0:34:49 > 0:34:52We saw photographs come back and they showed some minor
0:34:52 > 0:34:55scuffing to the door in a sort of brushing motion,
0:34:55 > 0:34:59and we'd also lost the back of the wing mirror off the car.
0:34:59 > 0:35:02Very indicative of a minor impact,
0:35:02 > 0:35:04rather than actually a dent
0:35:04 > 0:35:07which you would expect from a side-on collision.
0:35:07 > 0:35:13With the claimant's version of events suggesting a violent shunt had taken place,
0:35:13 > 0:35:18it was time to check the bus CCTV to see what had actually occurred.
0:35:18 > 0:35:21This footage clearly shows...
0:35:21 > 0:35:25I mean, this chap and his wife have both said they were thrown forwards
0:35:25 > 0:35:26and backwards. Take a look at that.
0:35:26 > 0:35:28The car doesn't even move.
0:35:28 > 0:35:30So, they haven't been tossed around
0:35:30 > 0:35:35like an old pair of socks in a tumble dryer - as alleged.
0:35:35 > 0:35:37We're talking about a push against a wing mirror on a car.
0:35:37 > 0:35:40You push a wing mirror and it just folds.
0:35:40 > 0:35:43No way. No way is that car moving from hitting that wing mirror.
0:35:45 > 0:35:48Hardly the automotive carnage the claimants had suggested.
0:35:48 > 0:35:50When we actually looked into this claim and investigated it
0:35:50 > 0:35:54thoroughly, looking at the CCTV footage,
0:35:54 > 0:35:58it soon became apparent that this was a very low-speed impact.
0:35:58 > 0:36:02We couldn't really see how anyone
0:36:02 > 0:36:04could have sustained any movement within this vehicle
0:36:04 > 0:36:09following on from this very innocuous collision, really.
0:36:09 > 0:36:12And despite submitting a claim of over £8,000,
0:36:12 > 0:36:16the driver of the car was prepared to settle it at the scene for quite a bit less.
0:36:16 > 0:36:21The claimant had gone to our driver on the day and had said that
0:36:21 > 0:36:24if you paid him £50, he would go away and not pursue the claim.
0:36:24 > 0:36:28Lee and the claims team had seen more than enough to make a decision.
0:36:28 > 0:36:32We refused to accept that this barely perceptible coming together
0:36:32 > 0:36:34of vehicles could have caused
0:36:34 > 0:36:38anything like the level of injuries or damages that were being claimed.
0:36:38 > 0:36:40So, we refused to pay the claim,
0:36:40 > 0:36:45leaving the claimants with either the option of issuing proceedings on
0:36:45 > 0:36:47us, or dropping their claims.
0:36:47 > 0:36:49Despite the overwhelming evidence against them,
0:36:49 > 0:36:53the claimants decided to take the case to court -
0:36:53 > 0:36:55a decision they would regret.
0:36:57 > 0:37:01The judge just simply couldn't believe, when he'd seen the footage...
0:37:01 > 0:37:04He saw there's no movement in this car.
0:37:04 > 0:37:08It's quite obvious. So, it doesn't take the judge much to look at the footage and think,
0:37:08 > 0:37:10"This is just not right."
0:37:10 > 0:37:13So the judge has struck the claim out in its entirety,
0:37:13 > 0:37:16with an award for our costs in full.
0:37:16 > 0:37:20So, it's a very satisfactory outcome to a claim that, once we'd looked at
0:37:20 > 0:37:23the footage, really had no chance of succeeding.
0:37:23 > 0:37:25Despite his many years in the job,
0:37:25 > 0:37:29cases like this one are still keeping Lee on his toes.
0:37:29 > 0:37:31I still am surprised with
0:37:31 > 0:37:34the ridiculous claims we do get in sometimes
0:37:34 > 0:37:38and the barefaced cheek of some people and what they will go through
0:37:38 > 0:37:41just to try and make some easy money.
0:37:41 > 0:37:44Also, I'm always amazed that they still haven't cottoned on the level
0:37:44 > 0:37:47of investigations and detail that we will look into
0:37:47 > 0:37:49just to verify a claim.
0:37:49 > 0:37:50These people should really wake up
0:37:50 > 0:37:54before they consider submitting a claim to us.
0:37:59 > 0:38:01Now, if you're unfortunate enough to have something stolen,
0:38:01 > 0:38:04then so long as you're covered with an insurance policy,
0:38:04 > 0:38:07it can be replaced. In the event of a theft,
0:38:07 > 0:38:11insurance companies place a lot of trust in us being honest about what's been taken.
0:38:11 > 0:38:15But sadly there are those who attempt to bend the truth and
0:38:15 > 0:38:18think adding an item here or there won't really make a difference.
0:38:18 > 0:38:22The truth is, it's no different to going out and stealing that item.
0:38:22 > 0:38:24So, when insurers suspect this is happening,
0:38:24 > 0:38:28they'll do everything within their power to identify the fraud
0:38:28 > 0:38:31and stop it in its tracks.
0:38:31 > 0:38:33Home insurers can protect everything
0:38:33 > 0:38:37from the kitchen sink to the garden shed.
0:38:37 > 0:38:41David Berry's team at Lloyds Banking Group received a call from a customer
0:38:41 > 0:38:45who'd had a less secure part of his property targeted.
0:38:45 > 0:38:47In April 2015,
0:38:47 > 0:38:52he contacted us by phone and explained to us that the lean-to,
0:38:52 > 0:38:55which runs alongside the side of his house, had been broken into.
0:38:57 > 0:39:02We asked the customer what had been stolen at the time and he explained
0:39:02 > 0:39:03to us that he didn't think that
0:39:03 > 0:39:05the thieves had got fully into the lean-to
0:39:05 > 0:39:08because it appeared that they had only taken items
0:39:08 > 0:39:10that were quite close to the door.
0:39:10 > 0:39:12Although it could have been worse,
0:39:12 > 0:39:16the claimant reported that some expensive items had been taken.
0:39:16 > 0:39:18A number of items were stolen.
0:39:18 > 0:39:21There was a drill, which he wasn't actually that bothered about because
0:39:21 > 0:39:25he was more concerned about the fact he was a keen fisherman and a number
0:39:25 > 0:39:28of items that were clearly important to him had been stolen.
0:39:28 > 0:39:31Those items had been acquired over a period of time and also some of them
0:39:31 > 0:39:33were very, very recently purchased.
0:39:33 > 0:39:36And in fact they were very expensive. He estimated that the
0:39:36 > 0:39:39total value of the claim was in the region of £5,000.
0:39:39 > 0:39:40As the name suggests,
0:39:40 > 0:39:45lean-tos aren't usually the most solid or secure of structures and
0:39:45 > 0:39:47are commonly filled with low-value things.
0:39:47 > 0:39:52So, to be keeping five grand's worth of stuff in there was slightly odd.
0:39:52 > 0:39:55When we asked the customer to provide us with fuller details
0:39:55 > 0:39:57in terms of the description of the items,
0:39:57 > 0:39:59together with any receipts he had
0:39:59 > 0:40:02or details of where he bought the goods from,
0:40:02 > 0:40:06we also suggested to him that he might have photographs of any of
0:40:06 > 0:40:09these items that might also help us understand their value.
0:40:10 > 0:40:14As requested, the claimant promptly supplied the claims team with photos
0:40:14 > 0:40:16of the alleged stolen items.
0:40:16 > 0:40:18But there was one small problem.
0:40:18 > 0:40:21When we looked at the properties within the equipment, we identified
0:40:21 > 0:40:23that one of them was taken around about 20 minutes before he
0:40:23 > 0:40:25reported the claim to us.
0:40:25 > 0:40:27And the second one though was around about an hour,
0:40:27 > 0:40:31a little bit over an hour, AFTER the claim was reported to us
0:40:31 > 0:40:32over the phone.
0:40:32 > 0:40:35A puzzling discovery, which was put to the claimant.
0:40:37 > 0:40:41When we asked the customer to tell us when he had taken these photographs,
0:40:41 > 0:40:44he told us that they'd been taken over a period of time,
0:40:44 > 0:40:46going back maybe as long as two years.
0:40:47 > 0:40:52It was looking like the claimant had only managed to frame himself
0:40:52 > 0:40:54for a potential fraud.
0:40:54 > 0:40:57We challenged the customer over that and he admitted that whilst he had
0:40:57 > 0:41:00had some items of equipment stolen,
0:41:00 > 0:41:03the item actually in the photograph wasn't stolen.
0:41:03 > 0:41:04But he had added it to the claim.
0:41:04 > 0:41:06The claimant had come clean,
0:41:06 > 0:41:10but this lone confession didn't mean he was off the hook.
0:41:10 > 0:41:14We explained to him that as part of that claim was fraudulent,
0:41:14 > 0:41:16he wasn't entitled under the policy
0:41:16 > 0:41:19to any payment because it was now our right to cancel the policy
0:41:19 > 0:41:20on the grounds of fraud.
0:41:20 > 0:41:23So, the claimant wasn't going to receive a penny.
0:41:23 > 0:41:26But that wasn't the end of the investigation.
0:41:26 > 0:41:31We reported the matter to the Insurance Fraud Enforcement Department and when they
0:41:31 > 0:41:34interviewed the customer, he explained to them that actually
0:41:34 > 0:41:37nothing had been stolen from the shed.
0:41:37 > 0:41:41This keen fisherman had been baited by the false idea that submitting a
0:41:41 > 0:41:43fraudulant claim would pay off.
0:41:43 > 0:41:46Previously, he'd told us that a number of items had been stolen,
0:41:46 > 0:41:49valued at around £5,000.
0:41:49 > 0:41:51So, it really was a surprise to us when he actually did admit to the
0:41:51 > 0:41:53police that nothing at all was stolen.
0:41:53 > 0:41:57Despite the claimant's blatant and planned attempt to swindle his
0:41:57 > 0:41:59insurers, he narrowly avoided prosecution.
0:41:59 > 0:42:01As a result of that interview,
0:42:01 > 0:42:04and again because the customer was of previously good character,
0:42:04 > 0:42:07the police were prepared to deal with the matter
0:42:07 > 0:42:08by way of a police caution.
0:42:11 > 0:42:14Ifed will investigate any suspected fraud
0:42:14 > 0:42:15and for insurers,
0:42:15 > 0:42:20having the boys in blue as an ally often proves invaluable.
0:42:20 > 0:42:23Had we not reported the matter to the police,
0:42:23 > 0:42:26it's very unlikely that we would've actually understood ultimately that
0:42:26 > 0:42:28nothing at all was stolen.
0:42:28 > 0:42:32Insurance companies are making it crystal clear that they are not soft
0:42:32 > 0:42:37targets and there will be serious consequences if anyone tries to defraud them.
0:42:37 > 0:42:41I honestly don't believe that customers sometimes realise the
0:42:41 > 0:42:45repercussions of what can happen if they're caught committing insurance
0:42:45 > 0:42:46fraud. Potentially,
0:42:46 > 0:42:49it could mean that the matter is reported to the police,
0:42:49 > 0:42:51which could lead to imprisonment or a suspended sentence.
0:42:56 > 0:42:59Insurance fraud in this country costs all of us money.
0:42:59 > 0:43:03But the days of no-questions-asked pay-outs are numbered.
0:43:03 > 0:43:07Insurers are getting ever more sophisticated technology to identify,
0:43:07 > 0:43:09track and prosecute fraudsters
0:43:09 > 0:43:14and courts are using new powers to put these criminals behind bars.