Episode 10 Claimed and Shamed

Insurance fraud has reached epidemic levels in the UK.

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

That's almost 3.6 million every day.

Deliberate crashes, bogus personal injuries, even phantom pets.

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

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

But insurers are fighting back,

exposing just under 15 fake claims every hour.

Armed with covert surveillance systems,...

Subject out of the vehicle.

..sophisticated data analysis techniques,

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

Police! Stay where you are!

..they're catching the criminals red-handed.

Don't lie to us!

All those conmen, scammers and cheats on the fiddle

are now caught in the act and Claimed And Shamed.

A husband and wife team of fraudsters

get some unwelcome visitors.

Police officers. Can you come to the door, please?

Some revealing CCTV footage proves to be comedy gold.

He's pacing around. He is very agitated.

I watched this back at triple speed

and I could hear the Benny Hill music playing the background.

An esure deal with a particularly hapless driver.

It was simply inconceivable that one individual could be so unlucky

to be involved in five separate road traffic accidents

in ten months.

Insurance companies are a meticulous lot.

They will comb through every detail of a claim,

to ensure that everything is as it should be.

As long as you've done nothing wrong, there's nothing

to worry about, but if you are defrauding your insurance provider,

it is more than likely that you'll get found out.

It might not happen right away but, eventually,

they will find you and come after you.

Fraud is a crime and the police are getting wise to it.

When an insurance company detects fraudsters,

they'll hand them over to IFED.

In 2012, the Insurance Fraud Enforcement Department was set up.

They are a dedicated police squad,

specialising in bringing those committing insurance fraud

to justice. To date, they've convicted over 200 fraudsters.

Simon Styles is IFED's financial investigator.

In 2014, he and the team were given a case to investigate

by a health insurance provider called Simplyhealth.

They wanted IFED to look into two of their policyholders.

Mr Rehman Khan and his wife Shagufta.

Simplyhealth had made some rather startling discoveries

about what this seemingly ordinary couple were up to.

The Khans had a joint policy since 2002

and they made a number of legitimate claims,

as well as fraudulent claims, over a ten-year period.

And it was only an internal audit ten years into their policy

that Simplyhealth realised something was wrong.

They found that 300 claims had been made on the policy

over the period of time.

As a result of the audit and further investigations,

it was discovered that 245 of those claims were fraudulent.

These 245 fraudulent claims added up to over £18,000

that had been handed out to the Khans by Simplyhealth.

The type of claims that were made by Mr and Mrs Khan,

over a ten-year period, were low-level claims.

A claims handler receiving that on their desk

wouldn't really bat an eyelid.

Unfortunately, these claims just slipped through the net.

So, by keeping each individual amount claimed low,

often under £100, Mr and Mrs Khan's fake claims went unnoticed.

What's more, some of the health care that the Khans were claiming for

was genuine.

There were some 25 different companies

that have been visited by the Khans.

They had all said that the Khan family had attended there,

at some point in the past ten years, but on minimal occasions.

And not the number of occasions that the Khans had claimed they did.

IFED suspected that the Khans had been using real invoices

as templates to produce fake ones.

They were also pretty sure that the couple weren't going to stop

putting in more claims any time soon.

We knew that we quickly had to speak to both Mr and Mrs Khan,

to make sure that we would stop any more fraudulent activity,

because the level and period of time and number of claims,

we knew that they would continue in their criminal activity.

IFED needed to act fast to stop the Khans,

but they needed hard evidence

to prove that the couple had been committing fraud.

And the only way to get this was to raid the Khans' home.

6.30am, Simon, along with Detective Sergeant Tom Hill, are on the move.

We're going to arrest two members of the same family

who have been committing health insurance fraud

over a ten-year period

by submitting fake, or altered, invoices for medical care

from various hospitals and other, sort of, health care providers.

Mr and Mrs Khan have no idea that a police unit is closing in

and officers hope that, by raiding early in the morning,

they've got more chance of them being in

and the IFED officers are out in force.

There's another team going to another address

and it will be a simultaneous arrest, if all goes to plan.

As with any raid, the police never know how suspects will react

and are trained to be vigilant.

It's just a question of securing entry,

in the first case, and making sure the premises is secure

and all the people inside are accounted for, for our own safety.

A few miles away, the second IFED team has arrived

at the address of the other suspect.

With raids like this, speed and surprise are everything.

Once alerted, suspects may make a run for it,

so with the exits covered,

the occupants of both houses are given a rude awakening.

Police officers. Can you come to the door, please?

Good morning.

Detective Inspector Ben Flanagan, from the City of London Police.

-Are you Rehman Khan?

-Yeah.

-Do you mind if we come in?

I'll speak to you. I'll tell you what's happening. OK?

-Who else is in the house?

-My wife.

-Your wife. Well, get them down.

-Are they upstairs?

-Yeah.

-And I'll speak to you all at once.

-They're going to have to wake up.

-Police.

The police are in luck, both Rehman and Shagufta are in.

Would you like to take a seat? I'll explain exactly what's happening.

-Yeah, sure.

-OK. We're detectives from the City of London Police.

Insurance Fraud Enforcement Department.

We've received an allegation from an insurance company,

a crime has been reported to us of fraud,

against Simplyhealth Insurance, OK?

So, because of that allegation, I'm going to arrest you, OK,

on suspicion of conspiracy to defraud.

You do not have to say anything, but it may harm your defence

if you do not mention, when questioned,

something which you later rely on in court.

Anything you do say may be given in evidence.

So, we can search the premises. We can interview you.

And, then, we'll take it from there.

Understandably shocked, Mr Khan claims that he's heard nothing

about this from his insurance company.

I'm ready to sort this out, if there is a problem,

-but they should talk to me first.

-OK.

Well, they say they have and there is a problem

and it's been reported as a crime,

so I'm going to deal with it now, as a police officer, OK?

The case is now in the hands of IFED,

which means the investigation will be run by its rules.

To see if the Khans are willing to cooperate,

Simon asks them to help him to locate any potential evidence.

As I say, we're going to search your whole house.

It simplifies it, if you can tell us where any documentation

in relation to any claims that you may have made are.

Is there anything down here? Or is it all upstairs? No. It's upstairs.

'Whenever I go on searches, such as these, I always ask

'the occupant, as I did with Mr Khan,'

where the documentation was.

He indicated various sideboards and cupboards and things

around the building,

but it gives you an idea but you never take that for granted.

You've always got to search everything

where you suspect it may be because, unfortunately, criminals do lie.

So, the team embark on a systematic search of the entire property.

We're looking for computer equipment

which may have been used to manufacture

fraudulent receipts and invoices.

We're looking for paperwork, in relation to these insurance claims

that are believed to be fraudulent.

They soon find a number of memory sticks and laptops,

which may have vital information stored on them.

Everything is bagged up and labelled,

ready to be taken away and examined by IFED's investigators.

But it was a seemingly unassuming find that no-one was looking for

that was to be crucial in cracking the case.

Tucked away in one of the Khans' cupboards

were several ink stamps and one had the word PAID on it.

We'll have that.

You never know what you're going to find

when you go through the front door.

You'd love to find little pieces of nuggets that you can use

that's going to assist in your prosecution.

Having a stamp with the word PAID on it,

which was exactly the one we believed was used

in the fraudulent invoices, where successful claims have been made,

finding something like that was immensely useful

and it's very satisfying when you find something like that.

The police search was proving to be a great success.

Simon turned his attention to the Khans' bank statements

found at their house.

Part of my job as a financial investigator is to establish what

bank accounts people have, but also to see what lifestyle they've got.

What it does show is that there's an income into the accounts

far in excess of what they could have legitimately have earned.

All the time, I'm totting it up, to see their outgoings

and the incoming. And does it make sense, or is there a gap?

Which would possibly suggest that they're living

from the proceeds of criminal activity.

As the search continues,

Simon finds yet more of the Khans' financial paperwork to investigate.

Just shown that this individual was on disability living allowance

and, therefore, is not working.

It was interesting to come across an instant access ISA.

There's a number of credits into the account,

over the last three or four years.

The latest credit was in May of last year of £2,000,

which shows the current balance is just over £4,000.

Which is interesting.

Something that I'll certainly put to her later in interview.

As to how she's able to accumulate £4,000 in an ISA.

More in-depth investigations reveal what Simon had suspected.

The unaccounted money found in the Khans' many bank accounts

matched the exact amount that had been paid out

by Simplyhealth from the fraudulent claims.

Simplyhealth paid out £18,000

and I found that the bank accounts

relating to the Khans had received £18,500.

So, this put the Khans right in the middle of this fraud.

With the raid at the Khans' house nearly complete,

at the other address,

the officers have found something which they believe could be vital.

IFED's Ben Flanagan calls to give the news.

We found details of a safety deposit box here.

So I'm thinking that there may well be documents

relating to this offence, or cash from it,

in the box.

With the searches at both properties over, Mr and Mrs Khan

along with the evidence seized are taken back to the station.

But the most important thing now

is that IFED gets its hands on the safety deposit box,

which could contain important evidence.

Still to come....

IFED hit the jackpot.

You can see, it would appear that we've got items of jewellery.

We'll be seizing all of this.

Now, if you drive, then you have to have car insurance.

It is simply not an option.

And if you're unlucky enough to have an accident that is undisputedly

your fault, it becomes clear why car insurance is so essential.

Especially if you've caused a lot of damage to another car

and, even worse, caused injuries to other people.

This exact scenario happened

to a man who'd had his car insured with esure.

For argument's sake, let's call him Mr A.

Mr A had driven into the back of someone at a set of traffic lights

and conscientiously called his insurers to report the accident.

The case was referred to a specialist insurance law firm,

Horwich Farrelly.

On the face of it, this was a run-of-the-mill road traffic

accident that esure see all too frequently.

The policyholder of esure was wholly at fault.

That policyholder freely admitted liability.

A seemingly-honest customer,

but then it's hard to make out an accident isn't your fault

when you've driven into a stationary vehicle.

Unfortunately for Mr A, the car he'd crashed into was full of people.

There were four people in the other car and all of them claimed

to have been injured and wanted compensation.

The first request to come in was from the driver.

This was a claim for personal injury,

valued at approximately £4,000,

as well as a claim for vehicle damage in the sum of 4,250.

This wasn't an unusually high amount for such a crash,

but something Mr A had said on that initial phone call

had immediately raised suspicions.

Esure felt it was highly unlikely for a crash like this

to have been reported just minutes after impact.

Surely the five people involved would have got out,

exchanged details, made sure no-one was seriously injured

and pulled in somewhere safe before making a call.

They decided to investigate Mr A further

and were shocked at their findings.

Just two weeks earlier, he had put in

a claim for another accident that he also said was his fault.

Whilst this claim was being investigated,

a third and further claim was intimated against esure,

with the policyholder once again freely admitting fault.

So, Mr A had been in three accidents that he admitted

were his fault in the space of just eight weeks.

And all had injured several people.

Either he was a terrible driver

or something more sinister was going on.

Esure carefully monitored Mr A for nearly a year

and, in that time, he was involved in a total of five claims.

It was simply inconceivable that one individual could be so unlucky

to be involved in five separate road traffic accidents in ten months.

So, what was going on?

Well, Ronan and his team had a good idea.

The policyholder had been offering inducements

to stage road traffic accidents.

He had accepted a policy with esure and had staged a number of

different road traffic accidents,

as well as another with a different insurer.

So, with five separate collisions in ten months,

esure and Horwich Farrelly suspected that Mr A had been paying people

to take part in deliberate car accidents.

In this case, they think Mr A paid the other driver to agree to

being crashed into so that he could put in a claim for thousands from

Mr A's insurance company.

It was believed that, if esure had paid out,

Mr A would get a large cut.

Esure refused to pay out the £8,250, but the driver, perhaps under

pressure from Mr A, was insistent, and he took esure to court.

The driver of the vehicle Mr A had crashed into

found himself in front of a judge.

At trial, the claimant was cross-examined thoroughly

by a barrister.

His evidence was completely undermined and began to unravel.

The claimant gave evidence as to his route on the day of the accident.

He had suggested he was going from a shopping centre to his own house.

The judge, knowing the area well, was able to identify,

after hearing our evidence,

that this route was extremely unlikely and would have taken

the claimant away from the route that he should have been travelling.

There were other inconsistencies

in the driver's account of the accident.

And, for the judge, the case was clear-cut.

The judge found that this claim was fundamentally dishonest

and the case was riddled with inconsistencies.

There was no way that the judge believed any aspects

of the claim that was pursued.

The driver of the car didn't receive a penny

of the £8,250 he was claiming. But the judge went further,

ordering him to pay £13,000 to esure, to cover their costs.

OK, let's return to North London now, where Ifed are continuing

to search the home of Rehman and Shagufta Khan,

who are suspected of making no less

than 245 fraudulent health insurance claims.

So far, officers have seized several items, including laptops

and memory sticks, which could all be key in proving the Khans' guilt.

Crucially, they also found a rubber stamp that they believe

was being used by the Khans to make their fake invoices look real.

We have a "paid" one.

-Can have that. You got a bag with you?

-Yeah.

So I'm going to seize them as evidence of the offence.

The operation's gone well.

But there's still more work to be done, as the team that raided

the other property made an interesting discovery that

needs to be investigated.

We've found details of a safety deposit box here.

The Khans are being taken to the police station for questioning.

After obtaining a warrant,

another team head off to check out the deposit box.

Traditionally, items of high value are stored in these boxes,

so the Ifed team are keen to discover exactly what's inside.

It would appear that we've got items of jewellery.

Little ingots here, look. Fine gold, 10g. Ten-gram ingots, look.

We will be seizing all of this.

The box is packed full of items which look to be very valuable

and could be vital evidence

in the investigation against Mr and Mrs Khan.

This haul could be worth a fortune.

Until we get that appraised,

we're not going to know exactly what the value of that is.

But it will be very interesting, because, obviously,

they're going to have to account for those items.

And they're going to have to prove to us that those items were obtained

legitimately and not as the result of any criminal activity.

Unfortunately, the Khans were unwilling to assist the police

in their investigations, as Simon Styles recalls.

Both Mr and Mrs Khan were arrested and taken to

a local police station, where they were later interviewed.

They gave various different accounts of it,

but no admissions relating to what they had actually done.

Apart from setting up adjustment policies and making claims.

But they were in denial and, unfortunately,

it meant that we were doing a lot more work than we needed to do.

Two years later, and it's the day Simon Styles and his team

have been waiting for - the Khans are at the Old Bailey.

To get to today, the day of sentencing,

has meant that a lot of hard work has been undertaken by Ifed.

These individuals were arrested in January, 2014,

so it's taken over two years to get where we are.

The investigation was much bigger and lengthier,

due to Shagufta and Rehmen Khan saying "no comment"

in two interviews that took place post-arrest.

There was 25 individual companies that had to be spoken to

and statements taken from them.

I looked at maybe ten or 11 bank accounts belonging to the

Khan family, to see where the money had gone to.

So, it was an extensive investigation

and a lot of painstaking work went into it.

But this hard work paid off.

The haul of jewellery found in the safety deposit box

proved to be a red herring.

However, the evidence the team found during the raids and the

strength of the case Ifed put together against Rehman and Shagufta

Khan was overwhelming and the couple did eventually admit their guilt.

I've just come out from the Central Criminal Court, Court 2,

where Rehman and Shagufta Khan

were given 12 months' prison sentence.

The judge said because of the length of time that they'd actually

committed these offences, which was over ten-year period,

and nearly £19,000 they stole, the judge said he had no choice

but to give them a period of imprisonment.

There's one final bizarre twist to this tale.

The Khans obviously thought that if they were to pay most

of the money back, the judge would go easy on them.

He didn't.

But the couple had already handed Simon a large wad of cash.

It is very, very unusual.

I've never seen that before and never heard of it happening.

It's £15,000. I'm leaving here now to bank it and that goes back

to the victim of crime. And that is great news.

An excellent result.

Simplyhealth will be getting most of their money back and the

fraudsters who stole £18,500 from them over ten years are behind bars.

Now, I consider myself to be pretty relaxed behind the wheel,

but even I can feel the rage start to bubble

when I see roadworks approaching.

The inevitable lane closures, temporary lights that take an age

to change and, worst of all, traffic jams.

But imagine if, while stuck in roadworks traffic,

you were hit by a ten-tonne bus.

Lee Ingram works as a claims team manager for FirstGroup.

With a fleet of over 6,300 buses

driving around 40 UK cities,

there's bound to be the odd accident.

And it is Lee's job to manage the claims that come in.

He recalls a case involving an accident which took place

at some dreaded roadworks.

The claimant in this case is saying that, as they were stationary,

waiting to merge in at roadworks, we've gone past them

and collided with their stationary vehicle.

So, essentially, we've changed lanes into their car.

A clear-cut case, then.

If the car was stationary, then the bus driver must be at fault.

FirstGroup would have to pay out.

When the repair invoice actually came in,

we're looking at a really minor scuff to the car.

Slight damage to a wheel trim.

And the bus, the cost of possibly polishing out a scuff

on the paintwork and £4 for a new bottle of white spirit.

The repair costs were so low to both vehicles that even

a bottle of white spirit had been listed.

So, imagine Lee's shock when the people in the car

said they'd been badly injured.

Something about the claim smelt a bit off.

Despite what would appear to be a fairly-innocuous collision,

we still received a claim in the value of around about £10,000,

which would have been for the injuries themselves

and solicitors' fees.

You may be wondering how they got to such

a large amount of money for such a tiny collision.

Well, it was because the car driver and passenger were claiming

they had suffered whiplash injuries -

bad back and neck pains from the impact of the bus.

Lee wasn't entirely convinced

and with nearly every one of his buses fitted with CCTV,

he knew he could take a look at the footage, to help him

understand exactly what had happened.

When we look at the CCTV, we're expecting to see

a bus striking into the side of a stationary car, causing it to move.

For someone to have whiplash injuries, there will have had

to have been a moment of impact between the two vehicles.

So, Lee was on the hunt for the footage which showed this.

Here comes the bus now.

I mean, it's just going to brush the wing of this vehicle.

Now, look for movement in the vehicle, because if you can see it,

can you let me know? Because I can't see that vehicle move.

So, I don't think it happens.

And if there's no movement in that car,

then I don't know how either of those people are injured.

But there was something else seen in the footage

that turned the injury claim into one big joke.

If you watch this man closely,

he has put in a claim for soft tissue injuries

to his shoulders and his neck.

And yet, he doesn't stop, sort of, flapping and gesticulating.

He's moving, he's pacing around. He's very agitated.

I watched this back at triple speed and I could hear the Benny Hill

music playing in the background.

MUSIC: BENNY HILL SHOW THEME

No wonder he's injured. I was exhausted just watching him.

Not only did the CCTV show that it was unlikely that the driver and

passenger had suffered any serious injuries, it also went further

to show that, actually, the bus driver didn't do anything wrong.

Throughout this claim, the third party's solicitors were alleging

that we'd changed lanes into their client's stationary vehicle.

When we look back at the CCTV footage, we can clearly see

that the bus has just continued on its straight course.

But, due to the position of the roadworks,

the vehicles do actually come together.

But there's certainly no sudden veering from the direction

the bus was travelling in.

The footage had brought the entire claim to a grinding halt.

We had already received a claim for the repairs to the car

from their insurers.

Once we'd seen the CCTV footage, we sent it on to them, told them

what it showed, and we promptly received a reimbursing cheque

for the bottle of white spirit and the damage caused to our bus.

He even got the money back for the turps,

which must have boosted Lee's spirits no end.

From people chancing their luck, by exaggerating their injuries,

to organised criminal gangs,

insurance fraud hits all of us in the pocket.

But instead of getting away with it,

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