Episode 4 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 vehicle.

..sophisticated data analysis techniques...

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

Police, don't move! Stay where you are!

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

Just don't lie to us.

All those conmen, scammers and cheats on the fiddle

are now caught in the act...

and claimed and shamed.

Ifed raid the home of a suspected fraudster.

Not commonplace to keep laptops in your bathroom, is it?

..and CCTV catches out a would-be fraudster

eyeing up an opportunity to make some easy money...

That, to us, could look like he was searching for a suitable trip point.

..and a professional horse rider,

who claims an accident left her unable to ride,

puts in an award-winning performance.

All sorts of things can affect how much your car insurance will cost.

Do you a garage? What do you do for a living? How old are you?

One big factor, though, is location, location, location.

If you live on an inner-city street with high rates of car crime,

you are going to pay a lot more for you car insurance

than if you live in a remote village where cars might break down but are rarely broken into.

It's all about risk.

Unfortunately, there are those out there who try to bypass this risk

factor in order to make money.

A ghost broker is a middleman who will sell someone a policy

but then lie to the insurance providers about their details.

So they might say a person lived in rural Hampshire

when really they live in the city centre.

They'll buy a very cheap policy, then sell it on for a tidy profit.

However, the cover is worthless,

as many of the driver's details are totally made up.

That driver will think they're insured, but if they try and claim,

they'll soon find out that their policy is invalid.

It is, of course, totally illegal, but something that Tom Gardiner,

head of fraud at Aviva, has seen too many times.

This type of insurance fraud is particularly abhorrent because

it exploits and preys on the most vulnerable people in society.

They're sold policies and insurance which, when they need them, are worthless.

And everybody else is paying additional premiums because of

this type of activity.

Back in 2013, the team at Aviva started getting suspicious

that they were being targeted by a ghost broker.

What alerted us was when we tied a number of motor insurance policies

to just three bank accounts,

and things unravelled quickly from there.

Eventually, we were able to link over 150 policies to the same scam.

Tom and his team investigated the three bank accounts

that had been used on all these policies.

This led them to one name - Mr Maur Dumitru.

They quickly established exactly what they thought he'd been up to.

What Dumitru was doing,

alongside his job as a scrap metal worker in Manchester,

was taking out bogus motor insurance policies with Aviva

for friends and family,

he was deliberately grossly misrepresenting those policies

to get cheap cover.

These policies were entirely worthless to the people

that he was acting for.

One of the big things that Dumitru would lie about was where the people

he was getting policies for lived.

Manchester is an expensive place to get your car insured,

so he would say that they lived in the Scottish Highlands.

But he didn't always do his research particularly thoroughly.

In one instance, Dumitru had taken out 62 policies in a street

that only had 28 residences.

It was abundantly clear to Tom and his team

that they'd found their ghost broker.

Once we'd connected all of the policies to Dumitru,

we put together an evidence pack and handed it out over to Ifed.

The Insurance Fraud Enforcement Department, or Ifed,

is a specialist police unit

dedicated to tackling insurance fraud.

They'll use their expertise, detective work

and financial investigation to come after anyone committing

insurance fraud, be it for a few pounds or several million.

Sergeant Steven Holland and other Ifed officers picked up the case

from Aviva and wasted no time in starting their investigations.

Ifed immediately began research into Mr Dumitru's bank accounts to see if

money was going in and out to Aviva.

We also checked computer and telephone records

to see if any communication between himself and Aviva was happening

so we could substantiate the claims.

The police needed to prove indisputably

that Dumitru was the ghost broker.

And it didn't take long for this proof to emerge.

The key piece of evidence that we used was the computer,

and being able to trace the address of the computer

and some reasonably basic checks revealed Mr Dumitru's home address.

The police had all they needed.

They knew that Mr Dumitru's home computer

had been the one used to set up all of those policies.

All they needed to do now was to go out and arrest him.

It's 7am, and two of Ifed's finest, Detective Sergeant Tom Hill

and Detective Chief Inspector David Wood,

are on their way to Dumitru's house to apprehend him.

So, we've got a search warrant to search and we'll seize computer

equipment and mobile phones that we believe were used

to take out the policies.

A raid like this is always tense.

On any knock like this, we like to get in as quick as we can.

It's very important for all sorts of reasons -

officer safety, safety of the occupants,

and also for securing evidence -

that we go in quick, enter and take control of the premises.

David makes sure that all his team are ready for action.

What we're doing now is we're all getting in position,

we've got officers covering the back, should anyone try and get away,

or any evidence get discarded from the back of the property.

And then, once we're ready, we'll start knocking on the door.

-Open the door.

-Hello, police.

Open the door, please.

Police.

There definitely seems to be someone home,

but it takes a while for them to open up.

-Morning.

-Morning.

Police officers. We've got a search warrant for your address.

It's a result for the team.

Dumitru is in.

We're City of London Police...

Once inside, Ifed begin their search of the property.

-Do you speak English?

-Yes, a little.

OK, we have a search warrant,

so we've got a warrant to search this address.

Do you understand?

The court have issued a warrant that allows us to search this address.

The police need to understand everything the suspect is saying,

as it could be relevant to their case.

Dumitru might be talking about something that will affect Ifed's search of the property.

With no way of knowing, Tom has to interject.

Do you mind... Just stop a minute.

Do you mind just speaking in English? Just speak in English. OK?

-Otherwise, we'll just take one of you to the car and...

-OK, OK.

That's all right.

Upstairs, there's been a development.

We've found a lot of laptops.

It's not commonplace to keep laptops in your bathroom, is it?

And that find seems to spark many more.

They've found...

a pile of laptops in the wardrobe, so we will seize them.

Crucial to any Ifed investigation is to examine financial paperwork

to look for anything suspicious.

On one day, there are five separate payments

to the one insurance company, each going out...

sums between 40, 50, £60.

That is highly unusual and wouldn't normally happen

on a genuine policyholder's account.

So we've got five separate payments going out.

It's very good evidence for us.

In addition to the frequent payments to the insurance company,

there's also sums of money being deposited into the account.

Several deposits of £1,200, £150, £800.

So there's money coming into the account, which we suspect to be from

people that are buying the bogus policies from these suspects.

Busy bank account she's got there.

With the search complete, Ifed take Dumitru,

along with all the evidence seized at his house, back to the station.

Ifed had their man.

We interviewed Mr Dumitru and in that interview,

he stated that he believed he wasn't doing anything wrong.

And that the money going into his account,

that we had called a setting up fee, was actually just a cash present.

Ifed had more than enough evidence to charge Dumitru,

in spite of his attempts to brush off the allegations with outrageous lies.

But he wasn't going to go down without a fight.

Still to come, Mr Dumitru becomes...

a wanted man.

He then failed to attend court and effectively went on the run.

And a warrant was then issued for his arrest.

Now, if I was a singer,

I might consider getting my voice box insured,

or a boxer, my fists.

Dancer on Strictly, twinkle toes.

In fact, most sports people do decide to pay for extra insurance

to cover themselves in case of injury.

You can't earn money when you're out of the game.

Claire Mitten from i-Cog Claims Management remembers a recent case

involving a professional horse rider.

The claim came to us as a medical claim.

The insured had been on a horse, she dismounted the horse,

and as she did so, she turned her body at such an angle

that she twisted the muscles in her back and caused herself severe pain.

Sounds very unpleasant indeed, and the effects of such an injury on a

professional sportswoman were considerable.

The insured advised us that she was classified as totally disabled,

which basically meant she couldn't carry out her everyday activities.

She wasn't able to compete,

so therefore she was losing money at the same time.

Claire rang up the horse rider to hear about the accident first-hand.

The rider's account of the accident sounded grim and very painful.

However, Claire and the team at i-Cog have a vast amount of knowledge of patterns of behaviour

when someone's had a traumatic injury.

And for Claire, there was already cause for suspicion in this rider's story.

So, as soon as the injury happened,

the insured said the pain was so severe that it was ten out of ten.

She still didn't feel the need to phone an ambulance or a doctor.

For somebody that's stating that their injury is ten out of ten

and so severe, as she did,

the first port of call would be to phone an ambulance and get yourself

to A&E to get checked out, especially with a back injury.

No, no. No.

Two uncomfortable weeks later,

the rider finally went to hospital and stayed overnight.

During that time, she received painkiller injections in her back.

So the horse rider admitted that just a couple of weeks after her injury,

she went to France for a competition.

This was clearly something she shouldn't have done when claiming

for total disablement, which included all loss of earnings.

But the rider insisted it was a one-off.

Unbeknownst to the claimant,

the i-Cog team had done some background research and they knew

she was taking them for a ride.

Claire had found evidence that the rider had competed just three days

after her fall off the horse.

Yet, for months, she had been telling her insurers

she couldn't ride at all.

But it didn't end there.

Claire was in her stride.

Let's just review that last line.

"I have to make a living as well, you see."

Up till this point, the woman had said that she hadn't been able to

make a penny from her profession as a horse rider

and had been claiming for total loss of earnings.

For Claire, the finish line was in sight and she was odds-on favourite to win.

At this point, she tried to blame it on insurers.

She tried to explain that when she originally rang the insurance company,

they told her what to tick and they told her what information to put on

the claim form. This wasn't the case.

We'd already checked this out with the insurance company.

She was just trying to get as much money out of them as she possibly could at this point.

A success for Claire and the team at i-Cog.

Lying to your insurer makes your whole claim invalid,

so i-Cog recommended the rider received no further payments

and that she should also pay back the money for her hospital stay,

which she would have been entitled to, if only she'd stuck to the truth.

Now, I, like most people,

despair at over-the-top health and safety policies.

I mean, who doesn't mind their head?

Most of the time, anyway.

But if you're a shop owner and someone slips over on your wet floor

or trips on something you should have got fixed

and it was deemed to be your fault,

it can be very expensive to sort out.

For shopkeepers, taking out public liability insurance means that if

they do have to pay out on a claim for personal injury,

it's not quite so bad for business.

Allianz are an insurance provider that looks after many businesses and shops.

It's Mihir Pandya's job to deal with the claims that come in.

He recalls a case involving one of his clients.

We received our first notification of the claim in July 2013 when our

policyholder, who owns a small petrol station,

told us that he'd received a letter suggesting that somebody had tripped

on a cover outside on the forecourt.

The individual concerned sustained injuries to his neck,

back and shoulders.

With a claim this serious, the team at Allianz needed to see

any evidence of a potential trip hazard for themselves.

As is standard procedure in these types of claims,

we instructed one of our claims investigators

to go and talk to anyone who might be working at the petrol station

on the day in question,

to take photographs of the forecourt,

and just get a general feel of the circumstances.

They found there was a manhole on the forecourt

with a badly laid cover.

At this point in their investigations,

Allianz received a full written statement from the claimant,

outlining just how badly he'd been injured.

The claimant indicated that he was hurt to the point where he could not

walk home unaided, so therefore called a friend to come

and pick him up from the forecourt.

The man was claiming £2,500 in compensation.

And it seemed indisputable that the petrol station owner was at fault.

However, there was a twist.

The owner was adamant that no such fall had ever taken place.

Lucky for us,

it turned out that the owner of the petrol station had retained

CCTV footage for the day in question.

The team at Allianz spied the man in question at the premises

on that fateful day.

He's the one wearing the blue T-shirt,

and arrives with two other people.

What we have are three individuals crossing the forecourt...

..and they enter the petrol station...

..and they purchase cans of drink

and then they leave the petrol station and disappear.

Seemingly, the most dramatic thing to happen to the man that day was

buying a can of fizzy pop.

Confused, the investigators looked more closely at the footage.

You can see one of them, the individual in the white T-shirt,

kicking the ground.

And that, to us,

could look like he was searching for a suitable trip point.

So perhaps the claimant's friend noticed the manhole cover,

then they all went into the shop to buy fizzy drinks.

Suddenly, an idea of how to make some easy money

popped into the claimant's head.

He could say he'd tripped over that manhole cover.

But he wasn't banking on the premises having CCTV cameras.

In his statement, the claimant tells us that he was on his own

and after purchasing his drink, he left the petrol station,

tripped over the cover, landed on his hands and knees,

sustained injuries,

and because he was on his own and he couldn't get home unaided,

he called a friend to come and pick him up.

Looking at this, complete lie.

The CCTV footage had brought the claimant's story

tumbling to the ground and, unsurprisingly,

Allianz decided not to pay out.

They did however decide to take the matter to Ifed.

Ifed made arrangements to call the claimant in,

and within the interview,

the claimant made a full and frank admission

that this was completely made up and it was an attempt

to defraud Allianz insurance.

On this occasion, Ifed gave him a police caution.

It's disappointing that this wasn't taken to court and the claimant

receiving a custodial sentence,

but the fact is he received a police caution,

that means he's got a criminal record,

it means it goes on the insurance fraud register and it means that

he's not going to be able to do that again.

Let's head back to the Insurance Fraud Enforcement Department,

who are carrying out a dawn raid on a suspected ghost broker, Mr Maur Dumitru.

Open the door, please.

Under questioning, Dumitru started to be liberal with the truth.

We interviewed Mr Dumitru, and in that interview,

he stated that he believed he wasn't doing anything wrong,

and that the money going into his account,

that we'd called a setting up fee, was actually just a cash present.

Ifed had work to do.

They had to prove beyond any reasonable doubt

that Dumitru was guilty.

Two years later, and Ifed's hard work paid off.

The evidence against Dumitru was irrefutable.

At court, Mr Dumitru pled guilty to fraud by false representation.

And he was due to appear at the Old Bailey in July 2015.

On the day of Dumitru's sentencing,

the judge sat waiting for him to arrive. He waited and waited.

Dumitru never showed up.

He'd gone on the run.

We made concerted efforts to locate Mr Dumitru.

With efforts from ourselves and our colleagues at Greater Manchester Police,

we managed to locate him and he was arrested in Manchester.

Dumitru went underground for nine months before the police finally

caught up with him. This time, they weren't taking any chances.

He went back to the Old Bailey the following day and was remanded in

custody until he was sentenced.

He was sentenced to 18 months for fraud by false representation,

and also a further two months for failing to appear in court for sentencing.

A great result for Ifed and for Tom and his team at Aviva,

who had originally spotted the fraud.

So, Dumitru had cost the insurance company £200,000,

and for his fraudulent activity, plus his failure to appear at court,

he is now in prison for 20 months.

Whether it's exaggerating real injuries,

totally making up a story for a dodgy claim,

or masterminding insurance fraud on an industrial scale,

insurers are coming down hard on the people who think they can make

a quick buck with their scams and cons.

But the fraudsters need to think again,

as more of them than ever before are being caught in the act...

and claimed and shamed.