0:00:05 > 0:00:09Insurance fraud has reached epidemic levels in the UK.
0:00:09 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:17That's almost 3.6 million every day.
0:00:19 > 0:00:24Deliberate crashes, bogus personal injuries, even phantom pets.
0:00:25 > 0:00:29The fraudsters are risking more and more to make a quick killing
0:00:29 > 0:00:33and every year, it's adding around £50 to your insurance bill.
0:00:33 > 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 > 0:00:43Subject out of vehicle.
0:00:43 > 0:00:46..sophisticated data analysis techniques...
0:00:48 > 0:00:51..and a number of highly skilled police units...
0:00:51 > 0:00:53Police, don't move. 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 con men, scammers and cheats on the fiddle
0:01:01 > 0:01:02are now caught in the act
0:01:02 > 0:01:04and claimed and shamed.
0:01:10 > 0:01:14Today, a claimant's sickly sham is caught on camera.
0:01:14 > 0:01:16He comes out from seeing the specialist.
0:01:16 > 0:01:19He's unable to stand properly.
0:01:19 > 0:01:23He then walks round to the driver's seat with no apparent injury
0:01:23 > 0:01:26and drives the car away.
0:01:26 > 0:01:32A policyholder frames herself for a false claim with her phoney story.
0:01:32 > 0:01:37The identity of the seller was the same pawnbroking shop
0:01:37 > 0:01:39that the claimant worked in.
0:01:45 > 0:01:50And a cyclist's claim he was hit by a bus runs out of road.
0:01:50 > 0:01:53What you actually see is him hit a drain cover,
0:01:53 > 0:01:56the bike flips rather spectacularly, I might add,
0:01:56 > 0:01:58and then he hits the floor.
0:02:04 > 0:02:09Exaggerating or making up a personal injury claim is quite simply fraud
0:02:09 > 0:02:12and insurance cheats will often go to ridiculous lengths
0:02:12 > 0:02:15to convince the world they're hurt,
0:02:15 > 0:02:18sometimes delivering Oscar-worthy performances.
0:02:18 > 0:02:22But there'll be no awards when insurers catch on to the con.
0:02:24 > 0:02:27With thousands of motor-related whiplash claims
0:02:27 > 0:02:29made every year in the UK,
0:02:29 > 0:02:32insurers pay out millions of pounds in compensation.
0:02:34 > 0:02:38When genuine, it can be a painful and debilitating injury.
0:02:39 > 0:02:43When false, it's just a costly pain in the neck.
0:02:45 > 0:02:49John Beadle is RSA's UK counter-fraud manager
0:02:49 > 0:02:52and has witnessed the act of every blagger,
0:02:52 > 0:02:57charlatan and swindler who's tried to pull a fast one.
0:02:57 > 0:03:00He was asked to investigate what looked like an everyday claim.
0:03:02 > 0:03:07So, this gentleman had a genuine road-traffic accident
0:03:07 > 0:03:12where the driver of the car that we insured ran into the back of him.
0:03:12 > 0:03:15TYRES SCREECH
0:03:15 > 0:03:19Clearly, we admitted liability in this case and he reported
0:03:19 > 0:03:23that he was suffering from severe
0:03:23 > 0:03:26neck and back injuries
0:03:26 > 0:03:29and recurring headaches.
0:03:29 > 0:03:32These alleged injuries had reportedly left the claimant
0:03:32 > 0:03:35in a desperate situation.
0:03:35 > 0:03:42This gentleman said that his normal way of life was severely restricted,
0:03:42 > 0:03:46that he couldn't undertake any normal activity
0:03:46 > 0:03:50and he submitted a claim
0:03:50 > 0:03:52of £400,000,
0:03:52 > 0:03:55which is extremely high for what was
0:03:55 > 0:03:59a relatively straightforward rear-shunt car accident.
0:03:59 > 0:04:05Suspiciously high for what was reportedly a bad case of whiplash.
0:04:05 > 0:04:09And whilst I'm not a medical expert,
0:04:09 > 0:04:14it is very unusual for a straightforward whiplash injury
0:04:14 > 0:04:20to turn into a long-term incapacity, such as was being claimed here.
0:04:20 > 0:04:24In this case, this gentleman's injuries didn't appear
0:04:24 > 0:04:30to be getting any better and indeed to be getting worse
0:04:30 > 0:04:34and that initially aroused some suspicion.
0:04:34 > 0:04:37Well, there was one way RSA could find out
0:04:37 > 0:04:40just how bad the claimant's condition really was.
0:04:41 > 0:04:45So, we put some surveillance on this gentleman
0:04:45 > 0:04:49to enable us to gauge the actual level of incapacity
0:04:49 > 0:04:51that he was suffering from.
0:04:51 > 0:04:54The footage the surveillance team captured
0:04:54 > 0:04:56would prove incredibly revealing.
0:04:56 > 0:04:59Well, this gentleman had severe incapacity to his neck,
0:04:59 > 0:05:03his back and severe headaches.
0:05:03 > 0:05:10So, I would have expected to see his injuries related to how he was -
0:05:10 > 0:05:15difficulty in walking, unable to drive and so forth.
0:05:15 > 0:05:18What John actually saw was a little different.
0:05:18 > 0:05:22And in the first period of surveillance, as you can see,
0:05:22 > 0:05:26there is no apparent incapacity at all
0:05:26 > 0:05:29and he appears to be leading a normal life.
0:05:29 > 0:05:33Yup, looks as though he hasn't got a care in the world.
0:05:33 > 0:05:39It gets interesting when he starts to attend
0:05:39 > 0:05:41the medical specialists.
0:05:43 > 0:05:48As you can see here, where he's in Harley Street,
0:05:48 > 0:05:51and he comes out from seeing the specialist,
0:05:51 > 0:05:53he's unable to stand properly
0:05:53 > 0:05:58and is supporting himself by gripping hold of the railings,
0:05:58 > 0:06:01while he waits for his car to arrive.
0:06:01 > 0:06:05But the claimant would soon drop the act.
0:06:05 > 0:06:08He then slowly makes his way to the car
0:06:08 > 0:06:10and gets into the passenger seat
0:06:10 > 0:06:14and a relatively short distance away,
0:06:14 > 0:06:16the car stops, he gets out of the passenger seat,
0:06:16 > 0:06:20walks round to the driver's seat with no apparent injury
0:06:20 > 0:06:22and drives the car away.
0:06:22 > 0:06:24He may still have a slight limp,
0:06:24 > 0:06:27but it's a far cry from the scene of agony he performed
0:06:27 > 0:06:30just a few yards up the road.
0:06:30 > 0:06:32And he's clearly perfectly able to drive.
0:06:32 > 0:06:36This is absolute blatant exaggeration.
0:06:36 > 0:06:41He's presenting a severe level of incapacity
0:06:41 > 0:06:45to the medical specialists and then carrying on as normal
0:06:45 > 0:06:48as soon as he's away from those premises.
0:06:48 > 0:06:50It still makes me very angry
0:06:50 > 0:06:56that these people are so brazen in their attempts to obtain money,
0:06:56 > 0:06:58which they're clearly not entitled to.
0:06:58 > 0:07:01Caught on camera, the claimant's dash for cash
0:07:01 > 0:07:04was about to take a real blow.
0:07:04 > 0:07:10So, we presented this evidence to the defence solicitors
0:07:10 > 0:07:15and made a greatly reduced offer
0:07:15 > 0:07:17in settlement of the claim,
0:07:17 > 0:07:22aligned to what we would normally expect for a minor whiplash injury.
0:07:22 > 0:07:25So, the claimant was offered a few thousand pounds
0:07:25 > 0:07:30as opposed to the £400,000 he was originally after.
0:07:30 > 0:07:31But anything he received
0:07:31 > 0:07:35would potentially be dwarfed by what he owed.
0:07:35 > 0:07:42We also sent our evidence to the Department of Works and Pensions
0:07:42 > 0:07:47because this gentleman had also been claiming incapacity benefit
0:07:47 > 0:07:50and, no doubt, they would wish to speak to him
0:07:50 > 0:07:54about repaying that amount that they'd advanced him.
0:07:54 > 0:07:59No doubt that'll be an interesting conversation for the claimant.
0:07:59 > 0:08:03And this type of case is a constant scourge for insurers.
0:08:04 > 0:08:06It's difficult when you get people like this
0:08:06 > 0:08:12which clearly are grossly exaggerating the level of injury
0:08:12 > 0:08:15and incapacity which they have
0:08:15 > 0:08:21and are trying to dishonestly obtain almost an obscene sum of money.
0:08:21 > 0:08:24And the consequences of these exaggerated claims
0:08:24 > 0:08:27don't just affect insurance companies.
0:08:27 > 0:08:30These people, if they get away with it,
0:08:30 > 0:08:35are costing us all money because it adds to the cost of insurance
0:08:35 > 0:08:39in the sense of the premium that we all pay for our policies.
0:08:39 > 0:08:41So, it impacts everybody.
0:08:47 > 0:08:51Still to come, some travellers try and extend their trip
0:08:51 > 0:08:54with a case of alleged illness.
0:08:54 > 0:08:57This individual's daughter was supposedly very sick
0:08:57 > 0:09:00and very ill from both ends
0:09:00 > 0:09:03and all he did was contact a doctor on the beach.
0:09:08 > 0:09:11Now, for most of us, our mobile phones
0:09:11 > 0:09:12are part of our everyday lives.
0:09:12 > 0:09:15But their shrinking size and the fact we're constantly
0:09:15 > 0:09:18popping them in and out of our pockets or bags
0:09:18 > 0:09:20means they're prone to getting misplaced.
0:09:20 > 0:09:23Fortunately, there are insurance policies
0:09:23 > 0:09:25to cover us in the event our phones are lost,
0:09:25 > 0:09:27damaged or stolen.
0:09:27 > 0:09:29But as with every other type of insurance,
0:09:29 > 0:09:32not all claims are as straightforward
0:09:32 > 0:09:34as they first appear.
0:09:34 > 0:09:38For many, the modern smartphone barely leaves our side,
0:09:38 > 0:09:39day or night.
0:09:39 > 0:09:41So, if your device gets damaged or lost,
0:09:41 > 0:09:45it can feel like a disaster.
0:09:45 > 0:09:47Thankfully, there are people like Andy Morris
0:09:47 > 0:09:49who could have us selfie-ing again
0:09:49 > 0:09:52before the latest app update is obsolete.
0:09:54 > 0:09:57Assurant had recently replaced one customer's handset
0:09:57 > 0:10:00after a reported phone faux pas.
0:10:01 > 0:10:03This particular claim
0:10:03 > 0:10:06is for a high-end smartphone, a Samsung S7 Edge,
0:10:06 > 0:10:09which has a value of over £630.
0:10:10 > 0:10:14This claimant claimed that she had lost the phone
0:10:14 > 0:10:16while taking a selfie.
0:10:16 > 0:10:20Whoops! The claimant promptly reported the loss,
0:10:20 > 0:10:22revealing the phone wasn't the only thing
0:10:22 > 0:10:25in a bit of a state at the time.
0:10:51 > 0:10:55And even if the claimant could have held a conversation,
0:10:55 > 0:10:58her phone would have allegedly been pretty useless.
0:10:59 > 0:11:03This individual hadn't actually activated the phone
0:11:03 > 0:11:06and had only used it for selfie purposes.
0:11:06 > 0:11:09I mean, we all love a good selfie, but really?
0:11:09 > 0:11:11It seems quite unusual that somebody
0:11:11 > 0:11:16would spend that amount of money on a high-end smartphone
0:11:16 > 0:11:21and not use the telephone or data features that come with it.
0:11:21 > 0:11:23As with any claim,
0:11:23 > 0:11:27Andy's team ran standard usage checks on the claimant's handset,
0:11:27 > 0:11:30which revealed some sobering news.
0:11:32 > 0:11:34During the claims process,
0:11:34 > 0:11:37despite the claimant saying she'd never used it,
0:11:37 > 0:11:40or never registered the device with a network,
0:11:40 > 0:11:46we had evidence that the device was being used to make telephone calls.
0:11:46 > 0:11:49Initially, when we discussed the fact
0:11:49 > 0:11:52that we had usage information with the claimant,
0:11:52 > 0:11:54they stuck to their story.
0:11:54 > 0:11:57Concerned the handset was being used by somebody else,
0:11:57 > 0:11:59the call handler double-checked
0:11:59 > 0:12:01what the phone was being used for by the claimant.
0:12:21 > 0:12:24So, our sloshed selfie-er was adamant
0:12:24 > 0:12:28she hadn't been sending or receiving from the handset.
0:12:28 > 0:12:30But mobile phone data never lies,
0:12:30 > 0:12:33which means that someone had been.
0:12:35 > 0:12:37So, one of the things that our claims team did
0:12:37 > 0:12:42was track down the person who had been using the phone.
0:12:42 > 0:12:46What that demonstrated is that they had bought it,
0:12:46 > 0:12:49purchased this device brand-new and in the box.
0:12:49 > 0:12:53This suggested the claimant hadn't lost her phone
0:12:53 > 0:12:56and was sending all the signals of a false claim.
0:12:56 > 0:13:00When we spoke to the consumer who'd purchased the phone,
0:13:00 > 0:13:06the identity of the seller was the same pawnbroking shop
0:13:06 > 0:13:08that the claimant worked in
0:13:08 > 0:13:13and actually purchased the device from the claimant themselves.
0:13:13 > 0:13:17The call handler begins to quiz the claimant about her employment,
0:13:17 > 0:13:19which isn't well received.
0:13:32 > 0:13:35The evidence the Assurant claims team had
0:13:35 > 0:13:39strongly suggested the claimant was trying to pull a fast one.
0:13:39 > 0:13:45This piece of evidence confirmed to us that it's irrefutable.
0:13:45 > 0:13:49The claimant had sold the device to the user.
0:13:49 > 0:13:54The user had unknowingly and unwittingly purchased the device,
0:13:54 > 0:13:58but then, actually, the claimant was telling us a very different story.
0:13:58 > 0:14:01The call handler continues to question the claimant.
0:14:15 > 0:14:18So, when we presented that evidence,
0:14:18 > 0:14:22our claimant immediately hung up and we rejected the claim.
0:14:22 > 0:14:26The reaction from the claimant spoke volumes.
0:14:26 > 0:14:29On several occasions during this claim,
0:14:29 > 0:14:31we gave the opportunity of the claimant
0:14:31 > 0:14:34of providing additional information.
0:14:34 > 0:14:38Unfortunately, she rejected that opportunity.
0:14:38 > 0:14:41The claimant didn't get a replacement device
0:14:41 > 0:14:43or any monetary gain.
0:14:49 > 0:14:52Now, making the most of an opportunity when it presents itself
0:14:52 > 0:14:55is usually the right thing to do.
0:14:55 > 0:14:57But those who try and milk a situation
0:14:57 > 0:14:59to make bogus insurance claims
0:14:59 > 0:15:04will find their shameless opportunism anything but rewarded.
0:15:05 > 0:15:09FirstGroup operate public bus services across the UK
0:15:09 > 0:15:11and know all too well what happens
0:15:11 > 0:15:15when bikes and buses are vying for the same piece of tarmac.
0:15:18 > 0:15:20Lee Ingram is their fraud manager
0:15:20 > 0:15:22and sees a lot of personal injury cases
0:15:22 > 0:15:25involving these two modes of transport.
0:15:25 > 0:15:27We initially received a report of a claim
0:15:27 > 0:15:30where a bus had come into contact with a cyclist.
0:15:30 > 0:15:32The cyclist had been knocked from his bike
0:15:32 > 0:15:35and subsequently sustained injury and damage to his bicycle.
0:15:35 > 0:15:38Whenever a bus and a cyclist come together,
0:15:38 > 0:15:41it's a potentially fatal accident.
0:15:41 > 0:15:45Luckily, in this case, the claimant wasn't seriously injured.
0:15:45 > 0:15:48The circumstances as told to us were
0:15:48 > 0:15:51that the cyclist was travelling along in the cycle lane
0:15:51 > 0:15:57when a bus has overtaken the cycle and sort of veered towards him,
0:15:57 > 0:16:01causing him to hit the bus and be thrown to the floor.
0:16:01 > 0:16:04This particular claim would have been valued at around about £5,000,
0:16:04 > 0:16:06including legal costs.
0:16:06 > 0:16:09From the sounds of it, the claimant had had a lucky escape.
0:16:09 > 0:16:13Nevertheless, he was still pretty beaten up.
0:16:14 > 0:16:18The cyclist alleged that he'd sustained soft tissue injuries
0:16:18 > 0:16:24to his neck, his elbows, his left ankle and his knees.
0:16:24 > 0:16:26He had to go to A&E.
0:16:26 > 0:16:29Not surprisingly, he had hit the floor rather hard
0:16:29 > 0:16:30after being hit by a bus.
0:16:30 > 0:16:34FirstGroup take all claims extremely seriously
0:16:34 > 0:16:36and this one was treated just like any other.
0:16:36 > 0:16:39So, Lee and his team began to investigate.
0:16:39 > 0:16:41The initial claim that was submitted to us
0:16:41 > 0:16:44gave the claimant's version of events.
0:16:44 > 0:16:46Again, we would go on what he said
0:16:46 > 0:16:50until we had evidence to sort of say otherwise,
0:16:50 > 0:16:53so the next thing to do then is check the CCTV footage,
0:16:53 > 0:16:55which we always do in all cases.
0:16:56 > 0:16:58When we looked at the footage,
0:16:58 > 0:17:01we were expecting to see just a minor coming together of the bus
0:17:01 > 0:17:05and the cyclist and for him to be thrown off of his bike
0:17:05 > 0:17:06and then hit the road.
0:17:06 > 0:17:09But the circumstances were a little different
0:17:09 > 0:17:12to what had been originally described by the claimant.
0:17:12 > 0:17:15What you actually see is him hit a drain cover,
0:17:15 > 0:17:19then he hits the kerb, then he hits the bus,
0:17:19 > 0:17:21the bike flips rather spectacularly, I might add,
0:17:21 > 0:17:24and then he hits the floor.
0:17:24 > 0:17:27So, you can see how he's been injured,
0:17:27 > 0:17:30but the actual liability for that happening
0:17:30 > 0:17:32wasn't down to the bus driver.
0:17:32 > 0:17:34And this cyclist's opportunism
0:17:34 > 0:17:37didn't stop at tight gaps on the road.
0:17:38 > 0:17:40Yeah, he's sort of bent the truth a bit
0:17:40 > 0:17:42to try and fit in with some circumstances
0:17:42 > 0:17:45that may have entitled him to compensation.
0:17:45 > 0:17:47Well, after viewing the footage,
0:17:47 > 0:17:51no amount of bending, exaggerating or embellishing
0:17:51 > 0:17:53would alter Lee's position.
0:17:53 > 0:17:56Once we'd established the true facts of the situation
0:17:56 > 0:17:58by looking at the CCTV footage,
0:17:58 > 0:18:01we quickly sent that off to the claimant's solicitors,
0:18:01 > 0:18:04telling them we were repudiating the claim in full.
0:18:04 > 0:18:07We subsequently received a quite quick response from them
0:18:07 > 0:18:09telling us that they were no longer instructed
0:18:09 > 0:18:12and that their client had withdrawn his claim.
0:18:12 > 0:18:14Lee's stance on picking up the tab
0:18:14 > 0:18:17for other people's mistakes is crystal clear.
0:18:17 > 0:18:21People have a responsibility to look after themselves.
0:18:21 > 0:18:26I see plenty of instances where someone does something very stupid
0:18:26 > 0:18:28and then looks for someone else to blame it on.
0:18:28 > 0:18:30If you think you're entitled to make a claim
0:18:30 > 0:18:34just cos you've failed to take into account a drain cover, on your bike.
0:18:40 > 0:18:42Now, going away is a chance to relax,
0:18:42 > 0:18:45unwind and have a bit of fun.
0:18:45 > 0:18:48Sadly, though, all getaways must come to an end.
0:18:48 > 0:18:51However, there are holiday-makers
0:18:51 > 0:18:53who appear to see their travel insurance policy
0:18:53 > 0:18:56as the answer to extending that holiday feeling
0:18:56 > 0:18:58that little bit longer.
0:18:58 > 0:19:03Sun, sea, adventure, culture, wildlife.
0:19:03 > 0:19:06We all want different things from our great escape.
0:19:06 > 0:19:11But one thing we all need wherever we venture is travel insurance.
0:19:11 > 0:19:14Collinson Group offer a range of travel services
0:19:14 > 0:19:18to help protect holiday-makers, should something go wrong.
0:19:19 > 0:19:21Mathew Crawford-Thomas is their fraud manager
0:19:21 > 0:19:25and an expert at sniffing out spurious claims.
0:19:25 > 0:19:27He was handed one case to investigate
0:19:27 > 0:19:29which appeared to be just bad luck.
0:19:33 > 0:19:38We received a medical expenses claim for £1,400 for cancelled flights
0:19:38 > 0:19:41to return home due to being ill whilst in Goa.
0:19:41 > 0:19:46There's nothing worse than being ill and stuck in a foreign country.
0:19:46 > 0:19:48Due to the remote location,
0:19:48 > 0:19:52it was the policyholder's mum who sounded the alarm.
0:19:52 > 0:19:56The insured's mother rang up the day they were due to fly home.
0:19:56 > 0:19:59She confirmed to us that her son's daughter
0:19:59 > 0:20:02was suffering with severe vomiting and diarrhoea
0:20:02 > 0:20:05and couldn't return home on their due flight.
0:20:30 > 0:20:33It soon became clear that any chance the claimant
0:20:33 > 0:20:36and his allegedly ill daughter had of returning home
0:20:36 > 0:20:38had gone down the pan.
0:20:38 > 0:20:42We offered as much help as they required.
0:20:42 > 0:20:44However, it would appear that the insured
0:20:44 > 0:20:46had already cancelled his flights
0:20:46 > 0:20:48and was prepared to sit this one out.
0:20:48 > 0:20:50But this was far from the first time
0:20:50 > 0:20:52Mat had been presented with this type of case.
0:20:54 > 0:20:57We receive claims from faraway countries.
0:20:57 > 0:20:59Obviously, they're in Goa,
0:20:59 > 0:21:01people eat the food, drink the water.
0:21:01 > 0:21:04Sometimes, they get vomiting and diarrhoea.
0:21:04 > 0:21:08A severe case of this is not only extremely unpleasant,
0:21:08 > 0:21:12but also potentially dangerous without the appropriate treatment,
0:21:12 > 0:21:15which is exactly what first raised Mat's concerns
0:21:15 > 0:21:18after he listened to the call from the claimant.
0:21:20 > 0:21:22We were originally suspicious about the claim
0:21:22 > 0:21:24after listening to the telephone call.
0:21:24 > 0:21:27This individual's daughter was supposedly very sick
0:21:27 > 0:21:29and very ill from both ends
0:21:29 > 0:21:32and all he did was contact a doctor on the beach.
0:21:32 > 0:21:35One would think that you would take your own daughter to a hospital.
0:21:54 > 0:21:58So, the person the claimant sought medical help from on the beach
0:21:58 > 0:22:01was reportedly a qualified doctor.
0:22:13 > 0:22:15After listening to the telephone call from the insured
0:22:15 > 0:22:17directly from Goa, it was farcical.
0:22:17 > 0:22:19I'm a father myself.
0:22:19 > 0:22:22If my daughter was as ill as she was,
0:22:22 > 0:22:24I would have taken her directly to a hospital.
0:22:24 > 0:22:27And when evidence to support the case came in,
0:22:27 > 0:22:30it did nothing to ease Mat's suspicions.
0:22:31 > 0:22:33Once the claim form was received,
0:22:33 > 0:22:35it was received with little or no documentation.
0:22:35 > 0:22:38All we received was one letter from a doctor
0:22:38 > 0:22:42confirming that she was not fit to fly due to sickness and diarrhoea.
0:22:42 > 0:22:47There were no accommodation costs, no medical costs, nothing at all.
0:22:47 > 0:22:51Our next step was to employ the services of our agents in India
0:22:51 > 0:22:54to make contact with the doctor directly.
0:22:54 > 0:22:57This course of action would flush out the real truth
0:22:57 > 0:22:59behind the alleged illness.
0:22:59 > 0:23:01As soon as our agents contacted the doctor,
0:23:01 > 0:23:03the doctor gave up the ghost.
0:23:03 > 0:23:06He apologised profusely over the telephone
0:23:06 > 0:23:09to say that his daughter had come into his facility
0:23:09 > 0:23:12and offered him 500 rupees to write a letter
0:23:12 > 0:23:14to say that they couldn't make their flight.
0:23:14 > 0:23:18So, the doctor confirmed the illness was a complete fabrication
0:23:18 > 0:23:22and offered a full retraction of the not fit to fly note
0:23:22 > 0:23:24he had previously issued to the claimant's daughter.
0:23:24 > 0:23:28We sent a letter to the insured confirming that we'd found out
0:23:28 > 0:23:32that his daughter had in fact paid the beach doctor 500 rupees
0:23:32 > 0:23:33for him to write the letter
0:23:33 > 0:23:36and the fact that we had a letter from the doctor
0:23:36 > 0:23:39retracting that statement and we weren't prepared to pay his claim.
0:23:39 > 0:23:42To date, we've received no response from the insured.
0:23:48 > 0:23:50Now, thanks to the robust approach
0:23:50 > 0:23:52of insurance companies and the government,
0:23:52 > 0:23:55the days of cashing in with a bogus whiplash claim
0:23:55 > 0:23:57are well and truly gone.
0:23:57 > 0:24:00For some insurance cheats, though, the penny hasn't dropped,
0:24:00 > 0:24:05and they continue to try it on in the hope their scam will pay off.
0:24:05 > 0:24:08But, frankly, it's often the carelessness of these chancers
0:24:08 > 0:24:12that enables insurers to catch them out.
0:24:12 > 0:24:15For every motor accident reported in the UK,
0:24:15 > 0:24:19there are 2.7 whiplash claims as a result.
0:24:19 > 0:24:22That is a huge amount of personal injury claims
0:24:22 > 0:24:25insurers like Aviva have to deal with every year.
0:24:26 > 0:24:30Some claims will be completely genuine.
0:24:30 > 0:24:32And the others are referred
0:24:32 > 0:24:34to Aviva's director of casualty claims,
0:24:34 > 0:24:36Richard Hiscocks, to investigate.
0:24:36 > 0:24:41He was handed one case that needed his well-trained eye.
0:24:41 > 0:24:45We heard about this claim when the claimant alleged
0:24:45 > 0:24:47that he'd been injured
0:24:47 > 0:24:50after our customer reversed into him in a petrol forecourt.
0:24:50 > 0:24:53The claimant had a medical report
0:24:53 > 0:24:57that said they had moderate whiplash to the neck and back
0:24:57 > 0:25:00with a prognosis period of nine months.
0:25:00 > 0:25:02A seemingly minor accident,
0:25:02 > 0:25:05but with the alleged injuries worth several thousand pounds,
0:25:05 > 0:25:08the claimant would have to allay some serious concerns
0:25:08 > 0:25:11before he saw any money.
0:25:11 > 0:25:15The claimant said in his claim that he'd begun to feel the pain
0:25:15 > 0:25:18within an hour of the accident happening,
0:25:18 > 0:25:21although he hadn't sought medical attention for two months.
0:25:21 > 0:25:23And that is a little bit suspicious.
0:25:23 > 0:25:26One of the first things that alerted us to the fact
0:25:26 > 0:25:29that maybe not everything was right with this claim.
0:25:29 > 0:25:30That's a long time to wait
0:25:30 > 0:25:35for someone who's stated to be in a significant amount of pain.
0:25:35 > 0:25:37And it appeared the claimant's injuries
0:25:37 > 0:25:40weren't slowing him down at all.
0:25:41 > 0:25:43It was interesting that, on social media,
0:25:43 > 0:25:47the claimant had said that in the three weeks after the incident,
0:25:47 > 0:25:50when he was allegedly seriously injured,
0:25:50 > 0:25:53that he'd worked uninterrupted in his manual job.
0:25:53 > 0:25:59With moderate whiplash, you'd expect some curtailment of normal life,
0:25:59 > 0:26:02so you'd expect some physical activities to be difficult.
0:26:02 > 0:26:04Yeah, that is what you would expect.
0:26:04 > 0:26:08But the claimant was about to see his case lose all momentum,
0:26:08 > 0:26:09unlike him.
0:26:11 > 0:26:16He also put on social media about two months after the incident
0:26:16 > 0:26:18that he'd run in the St Helen's 10K race,
0:26:18 > 0:26:22which you wouldn't necessarily expect he could do at all.
0:26:22 > 0:26:25The claimant may have been a competitive distance runner,
0:26:25 > 0:26:28but his dash for cash was about to end.
0:26:28 > 0:26:31So, we were obviously surprised to find that somebody
0:26:31 > 0:26:33who was so injured was so active,
0:26:33 > 0:26:38which led us to the conclusion that this was a spurious claim
0:26:38 > 0:26:41and we have a duty to defend our customers in those cases,
0:26:41 > 0:26:43so we declined to pay this claim.
0:26:43 > 0:26:48But this guy was determined to get his claim over the finish line.
0:26:48 > 0:26:51After we said we were not going to pay this claim,
0:26:51 > 0:26:55the claimant's solicitors served notice on us
0:26:55 > 0:26:58at which point we provided them with the evidence that we had.
0:26:58 > 0:27:01The claimant's solicitors came off record at that point
0:27:01 > 0:27:03and said they no longer wanted to represent the claimant.
0:27:03 > 0:27:05A telling decision,
0:27:05 > 0:27:08but Aviva were still keen to pursue the claimant
0:27:08 > 0:27:11so the case proceeded to court.
0:27:11 > 0:27:16The judge agreed that the claimant had been fundamentally dishonest,
0:27:16 > 0:27:18which is a really good outcome for us.
0:27:18 > 0:27:21It means that our version of events, and more importantly,
0:27:21 > 0:27:24the version of events of our customer,
0:27:24 > 0:27:26were believed and vindicated.
0:27:26 > 0:27:28And there were certainly no medals on offer
0:27:28 > 0:27:31when the judge made his final ruling.
0:27:31 > 0:27:35We were awarded costs of £9,213,
0:27:35 > 0:27:38so instead of getting compensation
0:27:38 > 0:27:41and making a few thousand pounds out of it,
0:27:41 > 0:27:43he was actually out of pocket by over £9,000.
0:27:50 > 0:27:54From organised criminal gangs to exaggerated household claims,
0:27:54 > 0:27:57insurance fraud hits all of us in the pocket.
0:27:57 > 0:27:59But instead of getting away with it,
0:27:59 > 0:28:03more and more of these fraudsters are being claimed and shamed.