0:00:02 > 0:00:04SKIDDING AND CRASH
0:00:05 > 0:00:10Insurance fraud has reached epidemic levels in the UK.
0:00:10 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:17That's almost £3.6 million every day.
0:00:19 > 0:00:24Deliberate crashes, bogus personal injuries, even phantom pets.
0:00:26 > 0:00:29The fraudsters are risking more and more to make a quick killing
0:00:29 > 0:00:34and every 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 > 0:00:44That's the subject out of the vehicle.
0:00:44 > 0:00:46..sophisticated data analysis techniques...
0:00:46 > 0:00:47SKIDDING AND CRASH
0:00:49 > 0:00:51..and a number of highly skilled police units...
0:00:51 > 0:00:53Police! Stay where you are.
0:00:53 > 0:00:55..they're catching the criminals red-handed.
0:00:55 > 0:00:58Just don't lie to us.
0:00:58 > 0:01:01All those conmen, scammers and cheats on the fiddle are now
0:01:01 > 0:01:04caught in the act and claimed and shamed.
0:01:10 > 0:01:14Today, a man's grossly exaggerated insurance claim
0:01:14 > 0:01:18is scuppered as he can't help showing off to his mates.
0:01:18 > 0:01:22He was actually bragging that he was in line for quite a large payout.
0:01:22 > 0:01:25A woman gets confused by her own version of events.
0:01:26 > 0:01:29The customer firstly said she had reported it,
0:01:29 > 0:01:32then she hadn't reported it, but now she had reported it again.
0:01:32 > 0:01:35And a man discovers it's hard to prove you've suffered an injury
0:01:35 > 0:01:38when you've slept through the entire accident.
0:01:38 > 0:01:40This bus could have been attacked by a T Rex
0:01:40 > 0:01:42and this guy wouldn't have even woken up.
0:01:47 > 0:01:49Have you ever had that feeling
0:01:49 > 0:01:51when you think you might be being followed?
0:01:51 > 0:01:54Not nice, is it? Well, if you're committing insurance fraud,
0:01:54 > 0:01:57that might not just be your imagination.
0:01:57 > 0:02:01More and more companies are using expert surveillance gatherers
0:02:01 > 0:02:05when they suspect someone is trying to defraud them.
0:02:05 > 0:02:10QBE is an insurance company that looks after many large businesses.
0:02:10 > 0:02:12Rob Smith-Wright is one of their claims managers.
0:02:12 > 0:02:16Something that Rob and his team have to deal with
0:02:16 > 0:02:20are personal injury claims from people that work for his policyholders.
0:02:20 > 0:02:24If someone is hurt just doing their job, then they deserve compensation.
0:02:24 > 0:02:28Rob recalls a case involving a mechanic, injured at work.
0:02:28 > 0:02:30The circumstances of this incident were that the claimant was
0:02:30 > 0:02:32working for our policyholder.
0:02:32 > 0:02:36He was required to lift some heavy equipment and as he did so,
0:02:36 > 0:02:39he felt a pop in his back and sustained an injury.
0:02:39 > 0:02:42This was potentially a very nasty injury indeed,
0:02:42 > 0:02:46especially for someone who has a physical job.
0:02:46 > 0:02:50Initially, QBE offered £35,000 in compensation.
0:02:50 > 0:02:53However, the man wasn't happy with the figure, saying it should
0:02:53 > 0:02:57have been much higher due to the severity of his injuries.
0:02:57 > 0:03:00The claimant's account of his injuries suggested that
0:03:00 > 0:03:04he was living quite a severely disabled lifestyle.
0:03:04 > 0:03:11He was unable to walk, he had to use crutches, he was unable to drive.
0:03:11 > 0:03:16He also had issues with personal hygiene, relying on family members.
0:03:16 > 0:03:20All in all, he painted a picture of someone who was suffering
0:03:20 > 0:03:24severe pain and had a very large degree of disability.
0:03:24 > 0:03:26When we looked at the claim and we started to put
0:03:26 > 0:03:28a valuation on the symptoms that we were told,
0:03:28 > 0:03:31we would have had a valuation of around £400,000.
0:03:31 > 0:03:36However, it later came through the court that when he submitted
0:03:36 > 0:03:40his schedule of damages, that he was looking at near on £800,000.
0:03:40 > 0:03:42Not much short of £1 million,
0:03:42 > 0:03:44but then, this man was maintaining
0:03:44 > 0:03:47that his life had been ruined by his injuries
0:03:47 > 0:03:50and he no longer had the ability to make a living.
0:03:50 > 0:03:55With such a discrepancy between the £35,000 QBE had initially
0:03:55 > 0:04:00felt the man was entitled to and the £800,000 he wanted,
0:04:00 > 0:04:03they felt they needed to investigate further.
0:04:03 > 0:04:06And something they found gave them pause for thought.
0:04:06 > 0:04:10Our initial suspicions arose after the receipt of the medical records,
0:04:10 > 0:04:15which detailed the claimant's visit to his own physician,
0:04:15 > 0:04:20whereby he was diagnosed with a muscular injury.
0:04:20 > 0:04:24Furthermore, the physiotherapist's records also detailed
0:04:24 > 0:04:28muscular injury to the lower back with no pain radiating down to his legs.
0:04:28 > 0:04:32So no pain radiating down to his legs, yet he was claiming
0:04:32 > 0:04:35he couldn't walk, drive or have a bath without assistance.
0:04:35 > 0:04:37The team were confused.
0:04:37 > 0:04:42They had enough concerns to justify some secret filming of the injured man.
0:04:42 > 0:04:46So when the surveillance came in, the natural expectation would
0:04:46 > 0:04:51be to see someone who was struggling to walk and was unable to drive.
0:04:51 > 0:04:56But the surveillance footage showed something very different.
0:04:56 > 0:04:59So the first period of surveillance that we undertook on the claimant
0:04:59 > 0:05:03did show him in fact walking, using a crutch, rather than crutches
0:05:03 > 0:05:07but the mobility that he was displaying was far greater than he
0:05:07 > 0:05:11was alleging that he could undertake and furthermore, and rather
0:05:11 > 0:05:15more concerning, was that the claimant was actually driving a car
0:05:15 > 0:05:19and it was a manual transmission, so that would have required quite
0:05:19 > 0:05:22a bit of movement over and above what he was suggesting he could do.
0:05:23 > 0:05:29The man clearly had been injured but he seemed much more able than he was claiming.
0:05:29 > 0:05:31Not long after this initial surveillance,
0:05:31 > 0:05:35QBE were surprised to receive reports from medical experts
0:05:35 > 0:05:39which seemed to confirm the claimant's version of the extent of his injuries.
0:05:39 > 0:05:43One medical expert went so far as to say that the level of
0:05:43 > 0:05:48symptoms that he was displaying was that on par with someone who
0:05:48 > 0:05:51had suffered a significant spinal injury.
0:05:51 > 0:05:53Also, the claimant's own account of his lifestyle
0:05:53 > 0:05:58maintained that things are getting worse, not better.
0:05:58 > 0:06:01He now suggested that he considered himself completely disabled.
0:06:01 > 0:06:05He was using a wheelchair, again wasn't able to work,
0:06:05 > 0:06:07wasn't able to drive -
0:06:07 > 0:06:10pretty much suggesting that
0:06:10 > 0:06:13this injury had completely changed his life.
0:06:13 > 0:06:16The team at QBE had to know.
0:06:16 > 0:06:19If the claimant was suffering as much as he and now his medical
0:06:19 > 0:06:23expert suggested, then, of course, he deserved full compensation.
0:06:23 > 0:06:26But so far in their own investigations,
0:06:26 > 0:06:28they hadn't seen this.
0:06:28 > 0:06:32They decided to conduct some more secret filming.
0:06:32 > 0:06:36And once again, the man was seen to be much more able than he was claiming.
0:06:36 > 0:06:40Here, you can see the claimant again driving and in fact,
0:06:40 > 0:06:42everything here indicates that this man
0:06:42 > 0:06:46has mobility far in excess of what he's telling anyone
0:06:46 > 0:06:48and any other medical experts that he can actually do.
0:06:48 > 0:06:53We are very much of the opinion that we have someone who's grossly
0:06:53 > 0:06:57exaggerating their claim to a fraudulent degree and clearly,
0:06:57 > 0:07:01this man is attempting to maximise the amount of compensation
0:07:01 > 0:07:04that he is reasonably due.
0:07:04 > 0:07:08QBE contacted the medical experts that he'd used and showed them the footage.
0:07:08 > 0:07:12The medical experts pretty much came back and said that
0:07:12 > 0:07:16he had been inconsistent in his account.
0:07:16 > 0:07:20Clearly he was able to do much more and generally speaking,
0:07:20 > 0:07:23they were unable to rely on anything that he had told them.
0:07:23 > 0:07:25It wasn't looking good for the claimant.
0:07:25 > 0:07:30In fact, his story that he was severely disabled really didn't stand up.
0:07:30 > 0:07:34What's more, QBE uncovered further damning evidence from people that knew him.
0:07:34 > 0:07:38One of the witness statements was actually quite revealing
0:07:38 > 0:07:41in that the property that the claimant had rented,
0:07:41 > 0:07:45he'd actually disclosed that he was in the process of
0:07:45 > 0:07:48making an injury claim, so much so to the point that
0:07:48 > 0:07:52he was actually bragging that he was in line for quite a large payout.
0:07:52 > 0:07:54QBE had seen and heard enough.
0:07:55 > 0:07:58They disclosed their evidence to the injured man and his solicitors,
0:07:58 > 0:08:00who promptly dropped his case,
0:08:00 > 0:08:02leaving the man to fend for himself.
0:08:04 > 0:08:07The claimant decided he would be happy to accept the earlier
0:08:07 > 0:08:12offer from QBE of £35,000 after all.
0:08:12 > 0:08:14Our immediate reaction to that request from the claimant
0:08:14 > 0:08:18to accept the early offer...was immediately rejected.
0:08:18 > 0:08:19The case went to court.
0:08:19 > 0:08:22However, the claimant repeatedly failed to appear.
0:08:24 > 0:08:27QBE knew that any attempt to get the man to pay their court costs
0:08:27 > 0:08:29would be futile.
0:08:30 > 0:08:33However, they needed to get legal permission to reject the claim.
0:08:34 > 0:08:38We then made an application to the court, asking them to strike out the
0:08:38 > 0:08:43claim, due to the inconsistencies and the clear fraudulent nature.
0:08:43 > 0:08:45The court agreed and the claim was struck out under an abuse of
0:08:45 > 0:08:47process of the court's timetable.
0:08:47 > 0:08:50The man didn't receive a penny.
0:08:50 > 0:08:52This is a cautionary tale,
0:08:52 > 0:08:56as he had been genuinely injured and did deserve some compensation.
0:08:56 > 0:08:59But his greed got the better of him.
0:08:59 > 0:09:02And by exaggerating his injuries to such an extent,
0:09:02 > 0:09:04he's ended up with nothing.
0:09:10 > 0:09:12Still to come -
0:09:12 > 0:09:16an absent-minded claimant lies to his insurance company,
0:09:16 > 0:09:19forgetting the fact he's already told them the truth.
0:09:19 > 0:09:22The vital piece of evidence was the telephone call
0:09:22 > 0:09:25where the claimant confirmed he wasn't injured.
0:09:29 > 0:09:31Now, many of us will know that feeling,
0:09:31 > 0:09:34getting off an aeroplane after a long-haul flight.
0:09:34 > 0:09:36You're exhausted, jet-lagged, and basically,
0:09:36 > 0:09:39already feel as if you need another holiday.
0:09:39 > 0:09:42But as you walk through the airport, do you ever get that growing panic
0:09:42 > 0:09:45that you might have left something on the plane?
0:09:47 > 0:09:50It's easily done but if you do lose something whilst travelling,
0:09:50 > 0:09:53then there are companies like CEGA,
0:09:53 > 0:09:56who can assist you in getting the value of your items back.
0:09:56 > 0:09:59Simon Cook heads up their special investigations team
0:09:59 > 0:10:02and recalls just such a case.
0:10:02 > 0:10:05The claim we initially received was for a lost iPad
0:10:05 > 0:10:07which was left on an aircraft.
0:10:07 > 0:10:10The customer said she had been using her iPad on the plane on the
0:10:10 > 0:10:14way back from overseas and she had accidentally left it in the
0:10:14 > 0:10:15seat pocket in front of her.
0:10:15 > 0:10:18CEGA had no reason to doubt the claim, as it's such
0:10:18 > 0:10:20a common and easy mistake to make.
0:10:22 > 0:10:25However, there was one thing that didn't quite add up.
0:10:25 > 0:10:27Once we reviewed the claim for the iPad,
0:10:27 > 0:10:31we noted that it was a 3G model. However, once we checked the
0:10:31 > 0:10:34national database, we noted that it hadn't been blocked.
0:10:34 > 0:10:38We'd expect any lost items such as this or a mobile phone to be
0:10:38 > 0:10:42blocked with the network provider, to stop unauthorised usage.
0:10:43 > 0:10:46Perhaps this was just an oversight by the customer.
0:10:46 > 0:10:49Simon and his team waited for the paperwork to come in, to look
0:10:49 > 0:10:51into the case further.
0:10:51 > 0:10:54Around two weeks after the customer first contacted us,
0:10:54 > 0:10:58we received a claim documentation and we became very concerned to
0:10:58 > 0:11:02note that she had now introduced a new claim for a lost bag, having
0:11:02 > 0:11:06never mentioned anything about this claim when she first contacted us.
0:11:06 > 0:11:10The total value of both claims was around £800.
0:11:10 > 0:11:14So not a huge amount but that didn't matter to Simon and his team,
0:11:14 > 0:11:17whose suspicions were now further roused by their customer's
0:11:17 > 0:11:20sudden memory of a lost bag which she had said had contained
0:11:20 > 0:11:22some make-up and a pair of boots.
0:11:23 > 0:11:27They contacted the airport where the woman said she'd reported her losses.
0:11:29 > 0:11:32The lost-and-found department were extremely helpful and explained to
0:11:32 > 0:11:36us that they did actually have a report for the lost iPad
0:11:36 > 0:11:38but confirmed they had never ever received a report
0:11:38 > 0:11:40for the loss of a bag.
0:11:40 > 0:11:43When we asked the customer about this point, she was adamant
0:11:43 > 0:11:48that she had reported the lost bag to the airport.
0:11:48 > 0:11:50It was the customer's word against the airport's.
0:11:50 > 0:11:54So Simon and his team felt they needed to do more investigation.
0:11:54 > 0:11:56Once we explained to the customer that, at present,
0:11:56 > 0:12:00we weren't happy with both the claims submitted,
0:12:00 > 0:12:03which meant that we wouldn't be able to pay the claims at present,
0:12:03 > 0:12:06she decided to make a formal complaint about the fact that we
0:12:06 > 0:12:10WERE going to make further enquiries and wouldn't settle the claim.
0:12:10 > 0:12:11Following procedure,
0:12:11 > 0:12:15a CEGA complaints operator spoke to the customer.
0:12:15 > 0:12:17He asked her again about the loss report
0:12:17 > 0:12:18she had submitted to the airport.
0:13:14 > 0:13:16CEGA were confused.
0:13:16 > 0:13:20The customer was now admitting that she HADN'T reported the lost boots
0:13:20 > 0:13:24and make-up to the airport, despite earlier being adamant that she had.
0:13:25 > 0:13:28But the plot was about to thicken.
0:13:28 > 0:13:30Shortly after speaking to the complaints operator,
0:13:30 > 0:13:34the customer sent in an e-mail purportedly from the airport,
0:13:34 > 0:13:37confirming that she HAD lost the bag.
0:13:37 > 0:13:40From our perspective, we were even more concerned now,
0:13:40 > 0:13:44because the customer firstly said she had reported it,
0:13:44 > 0:13:47then she hadn't reported it, but now she had reported it again,
0:13:47 > 0:13:50because she had sent us this document through.
0:13:50 > 0:13:53The e-mail contained a genuine airport report of the
0:13:53 > 0:13:54lost bag and crucially,
0:13:54 > 0:13:58the date on it was the same date she'd reported the lost iPad.
0:13:59 > 0:14:02Perhaps Simon and his team had got it wrong after all.
0:14:02 > 0:14:05Suddenly, their customer had hard evidence that proved she had
0:14:05 > 0:14:09indeed lost and duly reported her bag as missing,
0:14:09 > 0:14:10along with the iPad.
0:14:12 > 0:14:15They got back in touch with the airport to clarify matters.
0:14:15 > 0:14:18The lost-and-found department at the airport told us that they
0:14:18 > 0:14:20did in fact have two reports -
0:14:20 > 0:14:22one for the iPad and one for the lost bag.
0:14:22 > 0:14:26However, it was concerning to note that the lost-bag report was
0:14:26 > 0:14:31only actually made after the day that she made the complaint to us,
0:14:31 > 0:14:35which was approximately six weeks after the date of the alleged loss.
0:14:35 > 0:14:37It seemed as though their customer,
0:14:37 > 0:14:39after putting down the phone to the complaints operator,
0:14:39 > 0:14:43e-mailed the airport to report her bag as missing.
0:14:44 > 0:14:49And Simon had a good idea about the mystery of the date on the form.
0:14:49 > 0:14:53Her e-mail been sent into them in a format called PDF -
0:14:53 > 0:14:57an electronic copy of a document, rather than an original file.
0:14:58 > 0:15:02Why would the customer need to send us this e-mail in PDF format?
0:15:02 > 0:15:06She could simply just go into her e-mail, push forward, put our e-mail
0:15:06 > 0:15:10address in and then it comes to us as the original e-mail.
0:15:10 > 0:15:13It was evident to us that the customer had sent us an
0:15:13 > 0:15:17e-mail in PDF format, because she had changed the actual true date
0:15:17 > 0:15:21that she reported the lost bag to the airport.
0:15:21 > 0:15:26The clouds were definitely beginning to darken over this customer's claim.
0:15:26 > 0:15:27But there was a final twist
0:15:27 > 0:15:29that would launch it into turbulent skies.
0:15:31 > 0:15:34During the call with the airport's lost-and-found department,
0:15:34 > 0:15:37we were actually told that the iPad had been found on the aircraft
0:15:37 > 0:15:40and they actually had e-mail communications between the
0:15:40 > 0:15:45customer and the airport, so she could have the iPad returned to her.
0:15:45 > 0:15:49This all predated the customer even contacting us to make the claim.
0:15:49 > 0:15:53Her story crash-landed and CEGA had heard enough.
0:15:54 > 0:15:56Due to the level of evidence that we obtained,
0:15:56 > 0:15:58we actually declined both the claims in full
0:15:58 > 0:16:03and this matter was in fact referred to the City of London police.
0:16:03 > 0:16:04In addition to this,
0:16:04 > 0:16:08the customer did in fact admit to fabricating the lost-bag claim.
0:16:12 > 0:16:14Now, memory's a funny thing, isn't it?
0:16:14 > 0:16:17I can remember moments that happened ten years ago
0:16:17 > 0:16:20but often haven't got a clue what happened last week.
0:16:20 > 0:16:23I've even been known to forget my lines for this show.
0:16:23 > 0:16:27Here's a story, though, that may well stick in the mind.
0:16:29 > 0:16:30You would think,
0:16:30 > 0:16:33given the meticulous nature of insurance companies,
0:16:33 > 0:16:36anyone attempting to defraud them would understand the
0:16:36 > 0:16:38importance of attention to detail,
0:16:38 > 0:16:43but many of these would-be fraudsters find it difficult
0:16:43 > 0:16:47to remember exactly what lies they've told and to whom.
0:16:50 > 0:16:54BLM are a firm of solicitors that represent many insurance companies
0:16:54 > 0:16:56who require legal assistance to fight fraud.
0:16:59 > 0:17:02Simon Hammond is a partner at the firm and recalls a case which,
0:17:02 > 0:17:05at first, seemed totally run of the mill.
0:17:06 > 0:17:11The claim that was received was originally for minor vehicle damage
0:17:11 > 0:17:15following a road traffic accident.
0:17:15 > 0:17:18The driver had collided into the rear of the claimant's vehicle.
0:17:18 > 0:17:21The value of the entirety of the damage
0:17:21 > 0:17:25just to the vehicle was just in excess of £600.
0:17:26 > 0:17:29This relatively small amount of money was duly paid out
0:17:29 > 0:17:32to the claimant for the damage to his car.
0:17:32 > 0:17:35There were no injuries to the man and it was case closed...
0:17:35 > 0:17:37or so they thought.
0:17:37 > 0:17:41Two and a half years later, the claimant got back in touch to say
0:17:41 > 0:17:45he had been injured in the collision and was still suffering.
0:17:45 > 0:17:49The claimant alleged that he had suffered soft tissue injuries to his
0:17:49 > 0:17:50neck and back.
0:17:50 > 0:17:53The injuries had affected his life,
0:17:53 > 0:17:56his day-to-day work life and home life.
0:17:56 > 0:18:00He'd had to cancel meetings, he had two weeks away from work
0:18:00 > 0:18:04and he alleged he was continuing to suffer whilst going about his
0:18:04 > 0:18:05day-to-day activities.
0:18:05 > 0:18:09The insurance company found it a little suspicious that it had
0:18:09 > 0:18:12taken the man two and a half years to tell them about his injuries,
0:18:12 > 0:18:16but they did seem significant, so they carefully went through
0:18:16 > 0:18:17the medical report.
0:18:17 > 0:18:20It became apparent there was further suspicions in the case
0:18:20 > 0:18:22because, on notifying the claim,
0:18:22 > 0:18:26the claimant alleged he had suffered neck injuries,
0:18:26 > 0:18:28whereby, upon his GP report being served,
0:18:28 > 0:18:31he only was suffering back injuries.
0:18:31 > 0:18:35So there was a minor inconsistency on the doctor's report -
0:18:35 > 0:18:38but really not enough to prove one way or the other whether this
0:18:38 > 0:18:40claimant's injuries were genuine.
0:18:40 > 0:18:44Luckily for BLM, insurance companies are extremely thorough.
0:18:44 > 0:18:46They keep their records in good order
0:18:46 > 0:18:48and they keep them for many years.
0:18:48 > 0:18:52The vital piece of evidence which the insurer had in this particular
0:18:52 > 0:18:55case was the telephone call,
0:18:55 > 0:18:58which was recorded 13 days post the accident,
0:18:58 > 0:19:01where the claimant confirmed he wasn't injured.
0:19:01 > 0:19:04By this point, court proceedings were underway.
0:19:04 > 0:19:07The forgetful claimant was trying to fleece the insurance company
0:19:07 > 0:19:11out of thousands of pounds in compensation for injuries
0:19:11 > 0:19:13he'd admitted he'd never had.
0:19:13 > 0:19:16Once BLM had gathered all of the evidence,
0:19:16 > 0:19:19we immediately served that upon the claimant,
0:19:19 > 0:19:23showing him the call recording that confirmed he wasn't injured.
0:19:23 > 0:19:24The outcome of the case
0:19:24 > 0:19:27was the claimant discontinued his proceedings.
0:19:27 > 0:19:30That would seem to indicate that he was caught out -
0:19:30 > 0:19:33in which he was claiming for items he wasn't entitled to.
0:19:33 > 0:19:37The insurance industry as a whole is seeing more and more of these
0:19:37 > 0:19:38types of late claims,
0:19:38 > 0:19:43which often come in years after the actual incident has taken place.
0:19:43 > 0:19:45They are naturally suspicious of them,
0:19:45 > 0:19:50especially given that many such claims are initiated by cold calls.
0:19:50 > 0:19:52You know, the ones that ask you
0:19:52 > 0:19:56if you've been recently involved in an accident.
0:19:56 > 0:19:59The industry is working very hard with the regulators
0:19:59 > 0:20:01to try and stamp out the nuisance calls
0:20:01 > 0:20:03which the public are receiving,
0:20:03 > 0:20:09which is no doubt encouraging and facilitating potentially
0:20:09 > 0:20:11fraudulent claims being made.
0:20:11 > 0:20:13With any luck, then,
0:20:13 > 0:20:16we'll all stop receiving those annoying calls very soon.
0:20:22 > 0:20:26Night buses - it's always an experience taking one.
0:20:26 > 0:20:28But whether you're at the end of a big night out or about to
0:20:28 > 0:20:30start an early shift at work,
0:20:30 > 0:20:33for many of us, they're a vital service.
0:20:35 > 0:20:40FirstGroup have a fleet of over 6,500 buses on the UK's roads,
0:20:40 > 0:20:43including many services that run through the night,
0:20:43 > 0:20:46so it will come as no surprise that FirstGroup
0:20:46 > 0:20:49see their share of claims from passengers.
0:20:50 > 0:20:53While the majority of these are straightforward,
0:20:53 > 0:20:55some aren't quite as clear-cut.
0:20:55 > 0:20:58When a suspicious claim does come in,
0:20:58 > 0:21:01it usually end ups on the desk of Lee Ingram.
0:21:01 > 0:21:04One of our buses was involved in an incident in the
0:21:04 > 0:21:07very early hours of a summer morning.
0:21:07 > 0:21:11The claimant said that he was an upstairs passenger on a bus.
0:21:11 > 0:21:12He admits he was drunk.
0:21:12 > 0:21:16He'd fallen asleep when the bus had hit some bollards -
0:21:16 > 0:21:19this has caused him to be jerked forward in his seat.
0:21:19 > 0:21:23The claimant alleged soft tissue injuries to his upper back,
0:21:23 > 0:21:24his lower back.
0:21:24 > 0:21:28He also said that he was suffering from travel anxiety caused by
0:21:28 > 0:21:30post-traumatic stress.
0:21:30 > 0:21:33There were a number of other passengers on the bus -
0:21:33 > 0:21:36it's a little bit strange that none of them were injured
0:21:36 > 0:21:40and yet this one person claims that he was injured as a result.
0:21:40 > 0:21:42At first glance, this incident
0:21:42 > 0:21:44certainly was a bit of a head-scratcher.
0:21:44 > 0:21:47Multiple injuries, post-traumatic stress,
0:21:47 > 0:21:49yet only one injured passenger,
0:21:49 > 0:21:53who was claiming a whopping £16,000 in compensation.
0:21:55 > 0:21:58As always, Lee and his team investigated further
0:21:58 > 0:22:01and it wasn't long before the legitimacy of the claim
0:22:01 > 0:22:03was cast in serious doubt.
0:22:03 > 0:22:07We were initially concerned about this claim when certain
0:22:07 > 0:22:10inconsistencies came out in the medical report.
0:22:10 > 0:22:13We'd already had a report from a physiotherapist saying that
0:22:13 > 0:22:15this gentleman had had his treatment
0:22:15 > 0:22:18and he was now 100% recovered from his injuries.
0:22:18 > 0:22:21Now the medical report had said
0:22:21 > 0:22:25that he was still suffering from his injuries.
0:22:25 > 0:22:28When we went to the police and asked them for a report of this incident,
0:22:28 > 0:22:31they advised that they had been told about the accident
0:22:31 > 0:22:35but they had it down as a damage-only situation.
0:22:35 > 0:22:37If there had been an injury,
0:22:37 > 0:22:39the police would have recorded that injury
0:22:39 > 0:22:41and turned up at the scene of the event.
0:22:41 > 0:22:44Unlike many companies who find themselves faced with
0:22:44 > 0:22:48personal injury claims, FirstGroup are in a fortunate position
0:22:48 > 0:22:52because, in cases like this, they have the ultimate eyewitness.
0:22:52 > 0:22:55Based on the issues with the medical evidence,
0:22:55 > 0:22:58the physio report, the police situation,
0:22:58 > 0:23:02we decided that the CCTV was well worth looking at.
0:23:02 > 0:23:05With at least a dozen cameras fitted to FirstGroup's buses,
0:23:05 > 0:23:08the CCTV would show Lee and his team
0:23:08 > 0:23:11the freak accident that left one unlucky passenger with a string of
0:23:11 > 0:23:15injuries and everyone else on the bus completely unscathed.
0:23:16 > 0:23:20When we looked at the CCTV, all we were expecting to see
0:23:20 > 0:23:25was this bus hitting some bollards, coming to a very abrupt stop
0:23:25 > 0:23:28and the claimant being sort of moved forward in his seat
0:23:28 > 0:23:31and clear signs of him being injured.
0:23:32 > 0:23:36Given the claimant's list of injuries, it's a fair assumption.
0:23:36 > 0:23:38However, unfortunately for the claimant,
0:23:38 > 0:23:42it couldn't be further from what the cameras actually captured.
0:23:42 > 0:23:44When we looked at the CCTV,
0:23:44 > 0:23:47it showed a very different set of events.
0:23:47 > 0:23:49The bus didn't hit bollards at all.
0:23:49 > 0:23:54It hit a small road sign, which had flipped up and hit the windscreen.
0:23:54 > 0:23:57The claimant was upstairs asleep.
0:23:57 > 0:24:00The impact does cause a slight movement -
0:24:00 > 0:24:05it's certainly no more than every time he comes around from his sleep.
0:24:05 > 0:24:09It's certainly not enough to have caused him the whiplash and
0:24:09 > 0:24:14the travel anxiety and the... the disaster that he is alleging.
0:24:14 > 0:24:16So let's get this straight.
0:24:16 > 0:24:18The bus never collided with any bollards,
0:24:18 > 0:24:21the claimant hadn't suffered any movement to cause the injuries
0:24:21 > 0:24:24he was claiming for and, on top of that,
0:24:24 > 0:24:28he was barely conscious when the so-called accident
0:24:28 > 0:24:30had even happened.
0:24:30 > 0:24:32The only thing that was clear from the footage
0:24:32 > 0:24:36is that the claimant was dreaming when it came to his claim.
0:24:37 > 0:24:40When we've got evidence such as CCTV,
0:24:40 > 0:24:43it's often easy to see where a physical injury
0:24:43 > 0:24:45could have been caused.
0:24:45 > 0:24:47When it comes to psychological injuries,
0:24:47 > 0:24:49it's not always as apparent.
0:24:49 > 0:24:53Post-traumatic stress is very serious in itself...
0:24:53 > 0:24:57It's caused normally by what would be deemed a life-threatening
0:24:57 > 0:25:00situation or a very serious set of events.
0:25:00 > 0:25:04Of course, to experience that, you do have to be conscious
0:25:04 > 0:25:06for it to actually have an effect on you.
0:25:06 > 0:25:09This bus could have been attacked by a T Rex
0:25:09 > 0:25:12and this guy wouldn't have even woken up.
0:25:12 > 0:25:15Unsurprisingly, it didn't take Lee and his team long to decide
0:25:15 > 0:25:18what their next course of action would be.
0:25:18 > 0:25:21Once we looked at the CCTV footage, we very quickly went back
0:25:21 > 0:25:23to the claimant's solicitors
0:25:23 > 0:25:25and told them we weren't going to pay this.
0:25:25 > 0:25:27But if the claim itself wasn't shocking enough,
0:25:27 > 0:25:30the reaction of the passenger's solicitors
0:25:30 > 0:25:32was even more jaw-dropping.
0:25:32 > 0:25:35Surprisingly, shortly after repudiating the claim,
0:25:35 > 0:25:40we received a county court claim form from the claimant's solicitors.
0:25:40 > 0:25:44We were under the impression that the CCTV was quite clear.
0:25:44 > 0:25:47Armed with what can only be described as concrete evidence,
0:25:47 > 0:25:50FirstGroup were more than happy to see this case through.
0:25:50 > 0:25:53There's no way we're not going to defend this claim to trial.
0:25:53 > 0:25:57We definitely thought we had the correct evidence,
0:25:57 > 0:26:00we were satisfied that the claim was questionable in itself,
0:26:00 > 0:26:03and we therefore instructed Horwich Farrelly Solicitors
0:26:03 > 0:26:05to defend our position.
0:26:05 > 0:26:09Mark Hudson at Horwich Farrelly took up the case.
0:26:09 > 0:26:11The first thing that we did was to review the file of papers
0:26:11 > 0:26:15and, upon doing so, we noted that the incident involved
0:26:15 > 0:26:17a collision between a bus,
0:26:17 > 0:26:20a double-decker bus, and a small road sign.
0:26:20 > 0:26:25So, on that basis, we were highly cynical.
0:26:25 > 0:26:29Upon watching the CCTV footage, this confirmed beyond any doubt at all
0:26:29 > 0:26:32that this claimant simply was not injured and, moreover,
0:26:32 > 0:26:36was just telling lies about what happened to him at the time.
0:26:36 > 0:26:40But despite the overwhelming evidence, the case went to court.
0:26:40 > 0:26:45Not surprisingly, the claimant was fairly awful in cross examination.
0:26:45 > 0:26:49There were so many inconsistencies that he really didn't know
0:26:49 > 0:26:52how to deal with the questioning that came at him from the
0:26:52 > 0:26:55barrister representing FirstGroup.
0:26:55 > 0:26:59And, well, it doesn't take a legal eagle to guess what happened next.
0:26:59 > 0:27:02The judge was completely unwilling to accept that this incident
0:27:02 > 0:27:05either or could or did cause injury.
0:27:05 > 0:27:09The judge therefore dismissed the claim in its entirety.
0:27:09 > 0:27:12It was another victory for FirstGroup,
0:27:12 > 0:27:14but sadly an all too familiar sequence of events
0:27:14 > 0:27:18and Lee is under no illusion as to what the future will hold
0:27:18 > 0:27:21when it comes to dishonest opportunists.
0:27:21 > 0:27:24I don't think that this type of claim will ever completely go away.
0:27:24 > 0:27:28It would have been quite easy for us to pay the claim at an early stage,
0:27:28 > 0:27:31cut our losses and walk away.
0:27:31 > 0:27:33That is absolutely against what FirstGroup do.
0:27:33 > 0:27:37When we are satisfied that we've got the evidence
0:27:37 > 0:27:39and a claim, in our opinion, is questionable,
0:27:39 > 0:27:43we will defend it to the ends of the earth...
0:27:43 > 0:27:46and this is exactly what's happened in this claim.
0:27:46 > 0:27:49Unlike the claimant in this one, you won't catch us napping.
0:27:53 > 0:27:58From organised criminal gangs to exaggerated household claims,
0:27:58 > 0:28:01insurance fraud hits all of us in the pocket.
0:28:01 > 0:28:03But instead of getting away with it,
0:28:03 > 0:28:06more and more of these fraudsters are being claimed and shamed.