Episode 5 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 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.

A pedestrian's claim

that he was clipped by a car wing mirror.

is caught on camera.

What we decided to do was take a look at the CCTV footage

from lots of different angles,

just to make sure that we hadn't missed the impact.

But it was nowhere to be found.

A man claiming he's too injured to work

appears to be fighting fit.

They were able to find video evidence of a claimant

fighting in a kick-boxing competition,

only five weeks after the accident.

And, in America, a father confesses to killing his son

in a shocking life insurance scam.

Now, if any aspect of an insurance claim is falsified,

then that's fraud.

Pretty straightforward, you'd reckon.

While scammers often think that providing fake details

to allow an innocent third party to make a claim will protect them

but they're wrong

because it is still fraud, pure and simple,

and insurers will pursue these cheats at all costs.

Whether you are hiring a car, bike, or cement-mixer,

these things will all be covered by insurance, should anything happen.

Scott Clayton is a fraud and investigations manager for Zurich,

and it's his job to deal with suspicious claims.

He was asked to review one case

where a hire company had leased professional camera equipment

to a customer travelling abroad to make a movie.

The claim we got was that Mr Kakaie

had put this video equipment into four holdalls

and checked them in on a flight from Aberdeen to Istanbul, via Heathrow,

and the bags had been lost somewhere in transit between the two places.

The value was quite significant

because it was very expensive camera equipment.

So, in total, it was approximately £189,000.

With such a massive loss, all eyes were on the airline.

However, lost luggage isn't unheard of.

It does usually turn up somewhere.

It's not very often that you get a suggestion that bags

have been completely lost,

with all the technology the airlines have tracking bags, etc,

so to suggest that four bags were lost between these airports

was quite suspicious, in its own right.

So, obviously, that prompted the investigation.

And there was one very obvious first port of call

for Scott's investigation.

We took steps to contact the airline because,

with the technology the airlines have these days

tracking bags through airports,

we wanted to find out exactly what records they had.

And as it turned out, the airline in question

was able to provide some very revealing information.

We were pleasantly surprised to learn

that the bags had actually been X-rayed

as they passed through the airport.

So, the images were clearly of significant interest to us.

But no-one could have predicted what these X-rays would -

or rather would not - show.

We were quite shocked to see that, instead of having £189,000 worth

of camera equipment, they had nothing in them.

This was crucial evidence,

as it competently disproved Kakaie's account,

which stated the camera equipment

had been checked in at the airport to begin with,

and strongly suggested foul play.

At this point, we're thinking

this is clearly somebody who's tried to claim that

he's lost all this camera equipment,

when he's probably kept it for himself

and even used it, sold it, whatever.

So it was a fraud.

And we were obviously keen to get the bottom of it.

At this point, it was looking likely that Kakaie had submitted

a completely made-up insurance claim to the hire company

in order to steal the camera equipment he had hired.

Clearly, when we got the X-ray images

showing that the bags were empty, this was the gotcha moment,

because the evidence was compelling and, armed with that,

we could then look to refer the matter to the police.

The case was passed on to the City of London Police's

Insurance Fraud Enforcement Department,

where it was handled by DCI Oliver Little and his team.

When we received the case, it was clear to us

that what we needed to do was go and see Mr Kakaie,

get his account, and find out if there's any property

linking him to that missing equipment at his home address.

Armed with a search warrant, IFED detectives paid Mr Kakaie a visit.

When we got to Mr Kakaie's address, we did a thorough search.

We were able to find five of the batteries of the cameras

that were supposedly stolen during this theft.

It was the hard evidence that detectives were hoping to find.

Kakaie was arrested and charged with theft

and fraud by false representation.

But when he was questioned, he refused to deviate from his script.

We interviewed Mr Kakaie on two occasions.

On the first occasion, he stuck to his version of events.

He put the items in the bags, as described, and they'd been stolen.

On the second interview, faced with the overwhelming evidence,

he didn't cooperate, he didn't speak, he just turned around.

His sudden stage fright would do him no good

as, by this point, IFED detectives

had secured all the proof they needed

that Kakaie was starring in his own criminal caper.

Taking all the evidence into account,

it was quite clear that Mr Kakaie had attempted

a fairly major fraud here.

He was after well over £100,000 for this camera equipment.

So, we put that through to the Crown Prosecution Service

and prosecuted him in the court.

The case proceeded to trial at the Old Bailey.

Taking it all together,

the evidence we presented to the court was compelling.

We had some of the items that he reported as being stolen

in his home address,

and his account of how they had moved

through the airports just wasn't true.

The evidence of the scanner was a critical part of the case.

After a six-day trial, Kakaie was found guilty

of two counts of fraud by false representation

and one count of theft.

And the penalty for his crimes would be severe.

After trial, at which Mr Kakaie

again tried to protest his innocence, he was found guilty

and convicted to a sentence of imprisonment for two years.

A hefty punishment for this movie-making fraudster,

which may have been reduced if he'd come clean.

I think the level of sentence reflects the amount of money

that he was trying to defraud, so the greed of Mr Kakaie,

and the fact that he never, ever admitted

that what he'd done had been wrong.

He never held his hands up. He kept sticking to his story.

This was a brazen attempt at fraud and, like so many others,

it's got them absolutely nowhere but in prison.

Still to come,

a woman secretly records her husband in an attempt

to get the truth about her son's death.

Now, we've all had near misses,

whether it's not looking before crossing a road,

or using quick reflexes to avoid a falling object.

While most of us are just relieved to be unscathed,

there are some people who see a near miss

as a chance to collect a juicy pay-out they don't deserve.

Cars, buses, trains, cyclists, angry dogs and rogue runners

are just a few everyday hazards that could cause you harm

if you happen to be in the wrong place at the wrong time.

BLM lawyer Sarah Hill, instructed by insurers Direct Line

to handle one personal injury case that appeared legitimate.

The circumstances surrounding the claim was that

the policyholder was leaving his employment

and he was on his way out of the business park in his vehicle

when he came across an obstacle.

There was a car with a pedestrian by the side of it,

another employee,

and the driver had to overtake to pass him to leave.

This doesn't sound good.

In doing so, it's alleged that he didn't leave enough room

between his vehicle and the pedestrian, and that his

wing mirror clipped the lower back of the pedestrian,

causing him injury.

The claim in total was around about £18,000.

It may have just been the car's wing mirror,

but it had clipped the claimant good and proper.

The injuries were serious enough for him to say that it impacted upon his

life for a period of seven months, and for four months in particular,

he was unable to do anything that was normal

in his life, such as gardening or going to the gym

or even undertaking his normal working duties.

The report suggested this claimant had really been through it,

but any sympathy for his case would soon disappear.

On the surface, it looked like a genuine claim,

that is until evidence started to come in.

A crucial piece of evidence that we obtained was

a copy of the CCTV footage for the business park.

Clearly, what you can see from the CCTV footage is that there was

no impact between the wing mirror and the lower back,

and there actually was enough room between the two,

and the claimant was clear of any overtaking manoeuvre.

Yeah, not the faintest of feather touches, but let's double-check.

We were quite surprised, actually.

What we decided to do was take a look at the CCTV footage from

lots of different angles just to make sure that we hadn't missed...

erm, the impact. But it was nowhere to be found.

It may have been close,

but the claimant's roadside shimmy had saved him.

And how would you expect someone who's just been hit by a car

to be feeling?

Rather bizarrely, the claimant, A, doesn't hold his back,

doesn't look as if there's been any impact,

he's certainly not crying

and he's walked away from the vehicle smiling.

But what about the claimant's reported injuries

and chronic pain?

He went to see a physiotherapist 12 days after the alleged impact

and he told the physiotherapist

that he was well, that his movement was fine.

The physiotherapist couldn't see any sign of injury in the lower back,

in the lumbar spine,

yet that completely conflicted with what he told the medical expert.

Miraculous...

considering he'd alleged to have suffered for seven months

following the accident.

Given the weight of evidence, the claim was repudiated.

What happened next was that the claimant issued legal proceedings,

which was quite a surprise,

given that the claimant had actually seen the CCTV footage at this stage.

But even conclusive video evidence wouldn't deter this claimant.

With all the evidence, the claimant decided to try his luck in court

and present his evidence to a judge.

He upheld the fact that, actually, there hadn't been an impact

and that the claimant hadn't told the truth

through the course of the proceedings.

The claimant may have had a near miss with the wing mirror,

but he would regret his brush with the law.

The outcome was the judge dismissed the claim on the basis that he found

that no impact had occurred, so no injury could've been sustained

and to penalise the claimant, the claimant was ordered to pay costs.

He's now facing a hefty bill of nearly £12,000 for his efforts.

And despite Sarah's experience,

she's still amazed by the behaviour of insurance chancers.

I am surprised at the extent and the level and the nature that

people will go to, in light of really strong evidence,

still to progress what in fact is a lie.

Now, if you've ever had an accident,

you may have been contacted by a claims management company

telling you that you're entitled to compensation and that making

a personal injury claim is easy and hassle free.

What they might not tell you is that making

a false or exaggerated claim is fraud,

and if your case is found to be bogus in any way,

then you alone are 100% responsible.

The days of submitting a cheeky whiplash claim for

a guaranteed pay-out are long gone, as insurance companies like Esure

now have a zero-tolerance attitude towards this type of activity.

Any suspicious claim received by Esure is investigated

and, if need be, referred to a specialist insurance law firm,

Horwich Farrelly.

Partner Ronan McCann recently handled an all-too-common case.

This was a claim for a personal injury

as a result of a road traffic accident,

so roughly £2,000. There was also a claim for vehicle repairs,

which cost around £500.

And it was Esure's policyholder who was at fault in one of the

most everyday accident scenarios on the road.

The circumstances to this accident was that it was after work.

The defendant was travelling home.

In front of him, in very heavy traffic, was a claimant.

No prizes for guessing where this is going.

The defendant assumed the claimant was going to move forward

and he moved off at very low speed.

Unfortunately, the claimant didn't move,

and there was a slight kissing of the vehicles.

And this coming together really was a fleeting peck

on the claimant's rear end.

This accident was the most minor of impacts.

The defendant described it as a "touching of the vehicles".

The damages to both cars might have been minor,

but the same couldn't be said for the claimant.

The allegation from the claimant was that he sustained

a whiplash-type injury to his neck lasting four months.

And the claimant's first port of call after the accident

wasn't where you might expect.

The chronology after the accident was suspicious.

The claimant did not first attend upon his GP

to complain about his injuries

but instead went first to see solicitors to pursue

a personal injury claim.

So it seemed as if the claimant had money on his mind

rather than his health.

This immediately rang alarm bells.

Why would anybody first attend upon solicitors

to pursue a personal injury claim as opposed to attending

upon a GP to get their treatment for their injuries?

Good question, especially when you consider this guy's hobby.

The claimant, who was a keen amateur kick boxer,

suggested that he couldn't partake in any sports

during the period that he was injured.

Well, that's a given. Or so you'd think.

But the claimant's bid for compensation was about to take

a real body blow as Esure did some digging online.

They were able to find video evidence of the claimant

fighting in a kick boxing competition

only five weeks after the accident.

This showed the claimant taking kicks and punches to the head

and for Esure, this clearly suggested to them

that it was a fraudulent claim.

A quite amazing feat, considering the claimant

was reportedly suffering with chronic neck pain

as a result of the accident.

Only two weeks before the fight,

the claimant had attended upon a medical legal practitioner

and described that he was suffering from severe injuries.

In no way could somebody with severe injuries to the neck

take part in such a kick boxing fight.

Well, considering it's one of the most ferocious forms

of fighting, you'd assume not.

When the medical records were reviewed,

it seemed completely inconsistent that the claimant first

mentioned to the GP initially that his only injuries were to his neck.

It seemed to us that he invented the suggestion that his head

and knee injuries were as a result of the road traffic accident.

Ronan's team had all the evidence they needed to take action.

As a result, we took the view that we would disclose the video footage

and invite the claimant to discontinue.

But instead of throwing in the towel,

the claimant opted to go toe to toe with Horwich Farrelly in court.

When this case got to trial, the video footage was crucial.

When that was considered by the judge against

the inconsistencies in the chronology, in the evidence,

the judge could not accept a word that the claimant had said.

And when it came to deciding a verdict,

the decision didn't take long.

The judge dismissed the claimant's case

and looked at the video evidence and commented that the claimant

looked perfectly fit and healthy.

The judge found that the claimant was fundamentally dishonest,

and was ordered to pay approximately £8,000.

The kickboxer's claim had hit the canvas

and he'd ended up with a whopping court bill

for both solicitors' costs.

In my view, these individuals are convinced to bring claims

by accident management companies or claimant solicitors

who explain to them that they are extremely straightforward.

The result in this case shows the risks of anyone who believes that.

Although, the claimant in this case has a significant cost order,

he was very lucky that he didn't spend some time in prison.

We've all seen how far UK scammers will go to collect

an insurance pay-out, but fraudsters are an international problem.

In fact, our American cousins have it just as bad, with cases

that will shock you to your very core.

The rural farming town of Varick in Upstate New York

was home to the Karlsen family farm.

In 2008, 23-year-old Levi

was fixing his father's pick-up truck in the barn

when something went horribly wrong.

Tragically, Levi had been killed.

Father Karl and stepmother Cindy

had left Levi working alone earlier that day.

It appeared that he'd been trapped underneath the truck for hours.

At the time, investigators determined the event

just to be an awful accident.

That was until an anonymous family member contacted the police

with an unbelievable allegation.

They claimed Levi's death was no accident

and that he was the victim of a ruthless insurance fraud

perpetrated by his own father.

It was alleged Karl Karlsen had engineered Levi's fatal

accident in a plot to cash in on his son's life insurance policy.

As a result of this call,

the sheriff's office reopened the investigation into Levi's death.

Investigations revealed that Karl had persuaded Levi to take out

a life insurance policy worth 700,000 just 17 days

before his son's death.

Karl had also convinced Levi not to disclose a serious throat

condition he suffered from in fear that the policy might be rejected,

meaning this 700,000 insurance policy

had been obtained fraudulently.

Karlsen came under further suspicion as he had also persuaded Levi

to write a will on the morning of the day he died, making his

father the sole beneficiary of his life insurance policy.

Investigators were convinced that this was far more than coincidence

but as compelling as it was, the evidence was circumstantial.

They would need further proof.

So detectives turned to Karl's wife

and Levi's stepmother, Cindy Karlsen.

In 2012, Cindy was contacted by investigators.

To their surprise, she also had growing suspicions

that Levi's death was no accident. Six months after Levi's death,

Karlsen received over 700,000 from the life insurance policy.

Cindy explained how her husband went on a cash-feeding frenzy

as soon as he had the money.

Cindy hired a private investigator to dig into her husband's life.

The PI discovered a terrifying fact.

Without her knowledge, Karl had taken out various insurance

policies, which meant that in the event of Cindy's death, Karlsen

would be the sole beneficiary of assets and pay-outs

totalling 1.2 million.

Worried for her own life,

Cindy left Karlsen and they were officially separated.

However, Cindy agreed to co-operate with investigators and wear

a wire in the hope she could record her husband

confirming suspicions about Levi's death.

She arranged to meet Karl in a diner under the guise

of reconciling their marriage.

Remember, Karl previously claimed

to have had no knowledge of the accident

until he returned home with Cindy to find Levi underneath the truck.

He has just admitted he was present during his death.

The conversation Cindy covertly recorded

was far from a full confession but Karlsen did admit

he was there and in fact caused the alleged accident,

which contradicted everything he'd said to date.

Investigators now had all they needed to arrest

and interrogate Karl Karlsen.

Karlsen was interviewed for over nine hours,

in which he repeatedly denied planning to kill his son.

Initially, Karlsen stuck to his original story -

that he had returned home with his wife and found his son dead.

He then admits that he was there and, in fact,

caused the truck to fall on Levi.

Karlsen maintains this was a genuine accident

and due to the shock,

he was overwhelmed and was unable to help his trapped son.

While Karlsen acknowledged being responsible

for Levi's death, he was insistent it wasn't

a deliberate act to kill him.

Despite this, investigators had enough evidence.

Karl Karlsen was charged with second-degree murder

and insurance fraud.

Karlsen was so anxious to get his hands on the 700,000

from his son's fraudulently obtained life insurance,

he'd done the unthinkable.

In 2013, the case went to court, where,

faced with the overwhelming evidence against him,

Karlsen at last told the truth.

He admitted to intentionally knocking the pick-up truck

off its jack and leaving his son underneath to die.

Karl Karlsen pleaded guilty to murder.

In his closing statement,

the judge told Karlsen he was not fully human and said,

"You belong in prison and you belong there until you die."

Karl Karlsen was sentenced

to between 15 years and life behind bars

Karlsen had facilitated a 700,000 insurance fraud

and murdered his son to make sure he was paid every penny of that money.

He could now spend the rest of his life behind bars.

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.