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