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 > 0:00:23Deliberate crashes, bogus personal injuries,
0:00:23 > 0:00:24even phantom pets.
0:00:26 > 0:00:28The fraudsters are risking more and more
0:00:28 > 0:00:29to make a quick killing
0:00:29 > 0:00:33and, every year, it's adding around £50 to your insurance bill.
0:00:33 > 0:00:35But insurers are fighting back,
0:00:35 > 0:00:39exposing just under 15 fake claims every hour.
0:00:39 > 0:00:42Armed with covert surveillance systems...
0:00:42 > 0:00:44Subject out of vehicle.
0:00:44 > 0:00:47..sophisticated data analysis techniques...
0:00:49 > 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 criminals red-handed.
0:00:55 > 0:00:57Just don't lie to us!
0:00:57 > 0:01:01All those conmen, scammers, and cheats on the fiddle
0:01:01 > 0:01:04are now caught in the act and claimed and shamed.
0:01:10 > 0:01:11A pedestrian's claim
0:01:11 > 0:01:14that he was clipped by a car wing mirror.
0:01:14 > 0:01:16is caught on camera.
0:01:16 > 0:01:19What we decided to do was take a look at the CCTV footage
0:01:19 > 0:01:20from lots of different angles,
0:01:20 > 0:01:23just to make sure that we hadn't missed the impact.
0:01:23 > 0:01:26But it was nowhere to be found.
0:01:26 > 0:01:31And the muzzle is off when a woman's doggie deception is exposed.
0:01:31 > 0:01:35It was very clear that the puppy had damaged herself
0:01:35 > 0:01:39four hours before the policyholder had taken the policy out.
0:01:44 > 0:01:48And, in America, a father confesses to killing his son
0:01:48 > 0:01:51in a shocking life insurance scam.
0:02:08 > 0:02:11Now, if any aspect of an insurance claim is falsified,
0:02:11 > 0:02:12then that's fraud.
0:02:12 > 0:02:15Pretty straightforward, you'd reckon.
0:02:15 > 0:02:18While scammers often think that providing fake details
0:02:18 > 0:02:21to allow an innocent third party to make a claim will protect them
0:02:21 > 0:02:23but they're wrong
0:02:23 > 0:02:25because it is still fraud, pure and simple,
0:02:25 > 0:02:29and insurers will pursue these cheats at all costs.
0:02:31 > 0:02:34Whether you are hiring a car, bike, or cement-mixer,
0:02:34 > 0:02:38these things will all be covered by insurance, should anything happen.
0:02:40 > 0:02:44Scott Clayton is a fraud and investigations manager for Zurich,
0:02:44 > 0:02:47and it's his job to deal with suspicious claims.
0:02:47 > 0:02:49He was asked to review one case
0:02:49 > 0:02:52where a hire company had leased professional camera equipment
0:02:52 > 0:02:55to a customer travelling abroad to make a movie.
0:02:58 > 0:03:00The claim we got was that Mr Kakaie
0:03:00 > 0:03:04had put this video equipment into four holdalls
0:03:04 > 0:03:08and checked them in on a flight from Aberdeen to Istanbul, via Heathrow,
0:03:08 > 0:03:12and the bags had been lost somewhere in transit between the two places.
0:03:12 > 0:03:14The value was quite significant
0:03:14 > 0:03:16because it was very expensive camera equipment.
0:03:16 > 0:03:19So, in total, it was approximately £189,000.
0:03:19 > 0:03:23With such a massive loss, all eyes were on the airline.
0:03:23 > 0:03:26However, lost luggage isn't unheard of.
0:03:26 > 0:03:29It does usually turn up somewhere.
0:03:29 > 0:03:33It's not very often that you get a suggestion that bags
0:03:33 > 0:03:35have been completely lost,
0:03:35 > 0:03:38with all the technology the airlines have tracking bags, etc,
0:03:38 > 0:03:43so to suggest that four bags were lost between these airports
0:03:43 > 0:03:45was quite suspicious, in its own right.
0:03:45 > 0:03:48So, obviously, that prompted the investigation.
0:03:48 > 0:03:51And there was one very obvious first port of call
0:03:51 > 0:03:53for Scott's investigation.
0:03:53 > 0:03:56We took steps to contact the airline because,
0:03:56 > 0:03:58with the technology the airlines have these days
0:03:58 > 0:04:00tracking bags through airports,
0:04:00 > 0:04:02we wanted to find out exactly what records they had.
0:04:02 > 0:04:05And as it turned out, the airline in question
0:04:05 > 0:04:09was able to provide some very revealing information.
0:04:09 > 0:04:11We were pleasantly surprised to learn
0:04:11 > 0:04:13that the bags had actually been X-rayed
0:04:13 > 0:04:15as they passed through the airport.
0:04:15 > 0:04:18So, the images were clearly of significant interest to us.
0:04:18 > 0:04:21But no-one could have predicted what these X-rays would -
0:04:21 > 0:04:23or rather would not - show.
0:04:23 > 0:04:26We were quite shocked to see that, instead of having £189,000 worth
0:04:26 > 0:04:30of camera equipment, they had nothing in them.
0:04:31 > 0:04:33This was crucial evidence,
0:04:33 > 0:04:35as it competently disproved Kakaie's account,
0:04:35 > 0:04:37which stated the camera equipment
0:04:37 > 0:04:40had been checked in t the airport to begin with,
0:04:40 > 0:04:43and strongly suggested foul play.
0:04:43 > 0:04:45At this point, we're thinking
0:04:45 > 0:04:48this is clearly somebody who's tried to claim that
0:04:48 > 0:04:50he's lost all this camera equipment,
0:04:50 > 0:04:52when he's probably kept it for himself
0:04:52 > 0:04:54and even used it, sold it, whatever.
0:04:54 > 0:04:56So it was a fraud.
0:04:56 > 0:04:59And we were obviously keen to get the bottom of it.
0:04:59 > 0:05:02At this point, it was looking likely that Kakaie had submitted
0:05:02 > 0:05:06a completely made-up insurance claim to the hire company
0:05:06 > 0:05:09in order to steal the camera equipment he had hired.
0:05:09 > 0:05:11Clearly, when we got the X-ray images
0:05:11 > 0:05:14showing that the bags were empty, this was the gotcha moment,
0:05:14 > 0:05:17because the evidence was compelling and, armed with that,
0:05:17 > 0:05:20we could then look to refer the matter to the police.
0:05:21 > 0:05:24The case was passed on to the City of London Police's
0:05:24 > 0:05:27Insurance Fraud Enforcement Department,
0:05:27 > 0:05:30where it was handled by DCI Oliver Little and his team.
0:05:30 > 0:05:33When we received the case, it was clear to us
0:05:33 > 0:05:35that what we needed to do was go and see Mr Kakaie,
0:05:35 > 0:05:39get his account, and find out if there's any property
0:05:39 > 0:05:42linking him to that missing equipment at his home address.
0:05:42 > 0:05:47Armed with a search warrant, IFED detectives paid Mr Kakaie a visit.
0:05:47 > 0:05:51When we got to Mr Kakaie's address, we did a thorough search.
0:05:51 > 0:05:54We were able to find five of the batteries of the cameras
0:05:54 > 0:05:57that were supposedly stolen during this theft.
0:05:58 > 0:06:02It was the hard evidence that detectives were hoping to find.
0:06:02 > 0:06:05Kakaie was arrested and charged with theft
0:06:05 > 0:06:08and fraud by false representation.
0:06:08 > 0:06:12But when he was questioned, he refused to deviate from his script.
0:06:13 > 0:06:16We interviewed Mr Kakaie on two occasions.
0:06:16 > 0:06:20On the first occasion, he stuck to his version of events.
0:06:20 > 0:06:24He put the items in the bags, as described, and they'd been stolen.
0:06:24 > 0:06:27On the second interview, faced with the overwhelming evidence,
0:06:27 > 0:06:30he didn't cooperate, he didn't speak, he just turned around.
0:06:30 > 0:06:33His sudden stage fright would do him no good
0:06:33 > 0:06:35as, by this point, IFED detectives
0:06:35 > 0:06:38had secured all the proof they needed
0:06:38 > 0:06:41that Kakaie was starring in his own criminal caper.
0:06:41 > 0:06:44Taking all the evidence into account,
0:06:44 > 0:06:47it was quite clear that Mr Kakaie had attempted
0:06:47 > 0:06:49a fairly major fraud here.
0:06:49 > 0:06:52He was after well over £100,000 for this camera equipment.
0:06:52 > 0:06:56So, we put that through to the Crown Prosecution Service
0:06:56 > 0:06:58and prosecuted him in the court.
0:06:58 > 0:07:01The case proceeded to trial at the Old Bailey.
0:07:01 > 0:07:02Taking it all together,
0:07:02 > 0:07:06the evidence we presented to the court was compelling.
0:07:06 > 0:07:09We had some of the items that he reported as being stolen
0:07:09 > 0:07:11in his home address,
0:07:11 > 0:07:14and his account of how they had moved
0:07:14 > 0:07:16through the airports just wasn't true.
0:07:16 > 0:07:20The evidence of the scanner was a critical part of the case.
0:07:21 > 0:07:24After a six-day trial, Kakaie was found guilty
0:07:24 > 0:07:27of two counts of fraud by false representation
0:07:27 > 0:07:29and one count of theft.
0:07:29 > 0:07:32And the penalty for his crimes would be severe.
0:07:32 > 0:07:34After trial, at which Mr Kakaie
0:07:34 > 0:07:38again tried to protest his innocence, he was found guilty
0:07:38 > 0:07:41and convicted to a sentence of imprisonment for two years.
0:07:44 > 0:07:47A hefty punishment for this movie-making fraudster,
0:07:47 > 0:07:50which may have been reduced if he'd come clean.
0:07:50 > 0:07:53I think the level of sentence reflects the amount of money
0:07:53 > 0:07:56that he was trying to defraud, so the greed of Mr Kakaie,
0:07:56 > 0:07:59and the fact that he never, ever admitted
0:07:59 > 0:08:01that what he'd done had been wrong.
0:08:01 > 0:08:04He never held his hands up. He kept sticking to his story.
0:08:04 > 0:08:08This was a brazen attempt at fraud and, like so many others,
0:08:08 > 0:08:11it's got them absolutely nowhere but in prison.
0:08:19 > 0:08:21A man claiming he's too injured to work
0:08:21 > 0:08:23appears to be fighting fit.
0:08:23 > 0:08:27They were able to find video evidence of a claimant
0:08:27 > 0:08:30fighting in a kick-boxing competition,
0:08:30 > 0:08:33only five weeks after the accident.
0:08:33 > 0:08:38And a serial scammer's bogus travel insurance claims are unravelled.
0:08:38 > 0:08:40I do believe, at this point in time,
0:08:40 > 0:08:42he was fully aware that we were onto him
0:08:42 > 0:08:46and other insurers were requesting reimbursements of their funds.
0:08:57 > 0:08:59Now, we've all had near misses,
0:08:59 > 0:09:02whether it's not looking before crossing a road,
0:09:02 > 0:09:05or using quick reflexes to avoid a falling object.
0:09:05 > 0:09:08While most of us are just relieved to be unscathed,
0:09:08 > 0:09:10there are some people who see a near miss
0:09:10 > 0:09:15as a chance to collect a juicy pay-out they don't deserve.
0:09:16 > 0:09:22Cars, buses, trains, cyclists, angry dogs and rogue runners
0:09:22 > 0:09:26are just a few everyday hazards that could cause you harm
0:09:26 > 0:09:29if you happen to be in the wrong place at the wrong time.
0:09:29 > 0:09:33BLM lawyer Sarah Hill, instructed by insurers Direct Line
0:09:33 > 0:09:37to handle one personal injury case that appeared legitimate.
0:09:37 > 0:09:40The circumstances surrounding the claim was that
0:09:40 > 0:09:43the policyholder was leaving his employment
0:09:43 > 0:09:47and he was on his way out of the business park in his vehicle
0:09:47 > 0:09:49when he came across an obstacle.
0:09:49 > 0:09:52There was a car with a pedestrian by the side of it,
0:09:52 > 0:09:54another employee,
0:09:54 > 0:09:57and the driver had to overtake to pass him to leave.
0:09:59 > 0:10:01This doesn't sound good.
0:10:01 > 0:10:05In doing so, it's alleged that he didn't leave enough room
0:10:05 > 0:10:08between his vehicle and the pedestrian, and that his
0:10:08 > 0:10:11wing mirror clipped the lower back of the pedestrian,
0:10:11 > 0:10:13causing him injury.
0:10:13 > 0:10:17The claim in total was around about £18,000.
0:10:17 > 0:10:20It may have just been the car's wing mirror,
0:10:20 > 0:10:23but it had clipped the claimant good and proper.
0:10:23 > 0:10:27The injuries were serious enough for him to say that it impacted upon his
0:10:27 > 0:10:30life for a period of seven months, and for four months in particular,
0:10:30 > 0:10:33he was unable to do anything that was normal
0:10:33 > 0:10:37in his life, such as gardening or going to the gym
0:10:37 > 0:10:41or even undertaking his normal working duties.
0:10:41 > 0:10:45The report suggested this claimant had really been through it,
0:10:45 > 0:10:48but any sympathy for his case would soon disappear.
0:10:48 > 0:10:51On the surface, it looked like a genuine claim,
0:10:51 > 0:10:55that is until evidence started to come in.
0:10:56 > 0:10:59A crucial piece of evidence that we obtained was
0:10:59 > 0:11:02a copy of the CCTV footage for the business park.
0:11:02 > 0:11:06Clearly, what you can see from the CCTV footage is that there was
0:11:06 > 0:11:10no impact between the wing mirror and the lower back,
0:11:10 > 0:11:13and there actually was enough room between the two,
0:11:13 > 0:11:16and the claimant was clear of any overtaking manoeuvre.
0:11:17 > 0:11:22Yeah, not the faintest of feather touches, but let's double-check.
0:11:25 > 0:11:27We were quite surprised, actually.
0:11:27 > 0:11:31What we decided to do was take a look at the CCTV footage from
0:11:31 > 0:11:34lots of different angles just to make sure that we hadn't missed...
0:11:34 > 0:11:39erm, the impact. But it was nowhere to be found.
0:11:39 > 0:11:41It may have been close,
0:11:41 > 0:11:44but the claimant's roadside shimmy had saved him.
0:11:44 > 0:11:47And how would you expect someone who's just been hit by a car
0:11:47 > 0:11:49to be feeling?
0:11:49 > 0:11:52Rather bizarrely, the claimant, A, doesn't hold his back,
0:11:52 > 0:11:54doesn't look as if there's been any impact,
0:11:54 > 0:11:56he's certainly not crying
0:11:56 > 0:12:00and he's walked away from the vehicle smiling.
0:12:00 > 0:12:04But what about the claimant's reported injuries
0:12:04 > 0:12:06and chronic pain?
0:12:06 > 0:12:10He went to see a physiotherapist 12 days after the alleged impact
0:12:10 > 0:12:13and he told the physiotherapist
0:12:13 > 0:12:16that he was well, that his movement was fine.
0:12:16 > 0:12:20The physiotherapist couldn't see any sign of injury in the lower back,
0:12:20 > 0:12:22in the lumbar spine,
0:12:22 > 0:12:26yet that completely conflicted with what he told the medical expert.
0:12:26 > 0:12:27Miraculous...
0:12:27 > 0:12:30considering he'd alleged to have suffered for seven months
0:12:30 > 0:12:32following the accident.
0:12:32 > 0:12:36Given the weight of evidence, the claim was repudiated.
0:12:36 > 0:12:40What happened next was that the claimant issued legal proceedings,
0:12:40 > 0:12:42which was quite a surprise,
0:12:42 > 0:12:47given that the claimant had actually seen the CCTV footage at this stage.
0:12:47 > 0:12:52But even conclusive video evidence wouldn't deter this claimant.
0:12:52 > 0:12:57With all the evidence, the claimant decided to try his luck in court
0:12:57 > 0:13:00and present his evidence to a judge.
0:13:00 > 0:13:04He upheld the fact that, actually, there hadn't been an impact
0:13:04 > 0:13:07and that the claimant hadn't told the truth
0:13:07 > 0:13:09through the course of the proceedings.
0:13:09 > 0:13:12The claimant may have had a near miss with the wing mirror,
0:13:12 > 0:13:14but he would regret his brush with the law.
0:13:14 > 0:13:18The outcome was the judge dismissed the claim on the basis that he found
0:13:18 > 0:13:22that no impact had occurred, so no injury could've been sustained
0:13:22 > 0:13:27and to penalise the claimant, the claimant was ordered to pay costs.
0:13:27 > 0:13:33He's now facing a hefty bill of nearly £12,000 for his efforts.
0:13:33 > 0:13:35And despite Sarah's experience,
0:13:35 > 0:13:39she's still amazed by the behaviour of insurance chancers.
0:13:39 > 0:13:44I am surprised at the extent and the level and the nature that
0:13:44 > 0:13:49people will go to, in light of really strong evidence,
0:13:49 > 0:13:52still to progress what in fact is a lie.
0:13:57 > 0:14:01Pet insurance can give you the peace of mind that if your furry friend
0:14:01 > 0:14:05needs treatment, you won't be left facing huge vet bills.
0:14:05 > 0:14:07But there are some scammers who think that taking out
0:14:07 > 0:14:11a policy AFTER an incident has happened is acceptable.
0:14:11 > 0:14:14Well, it isn't. It is in fact insurance fraud.
0:14:16 > 0:14:20Whether you've got a mischievous moggy or a troublesome terrier,
0:14:20 > 0:14:23there'll be an insurance policy to cover your pet against
0:14:23 > 0:14:25unforeseen illnesses and accidents.
0:14:25 > 0:14:29Agria are a specialist in this field, and their managing director,
0:14:29 > 0:14:34Simon Wheeler, has a keen nose for spurious claims.
0:14:34 > 0:14:37His team received an everyday enquiry from a potential customer
0:14:37 > 0:14:41considering taking out one of their policies.
0:14:43 > 0:14:46The first time we heard from the policyholder
0:14:46 > 0:14:49was when she called for a quote on 8th February,
0:14:49 > 0:14:52and she wanted quotes for two dogs.
0:15:12 > 0:15:17So these two pooches were reported to be in tiptop condition.
0:15:17 > 0:15:20When we give quotations and sell people policies,
0:15:20 > 0:15:23we go through a number of questions, we take a lot of details,
0:15:23 > 0:15:25and one of the things that we ask
0:15:25 > 0:15:28is for the owner to confirm that the dog is fit and healthy.
0:15:28 > 0:15:31And there's a very good reason for that,
0:15:31 > 0:15:34which the call-handler relays to the customer.
0:15:47 > 0:15:50In this incident, the owner confirmed that both dogs
0:15:50 > 0:15:51were fit and healthy.
0:15:51 > 0:15:53Once the quoted had been received,
0:15:53 > 0:15:56the woman was eager to put the policy in place.
0:15:56 > 0:15:59The next time we heard from the policyholder was only
0:15:59 > 0:16:02a couple of hours later, so she called back on the same day
0:16:02 > 0:16:06and took out policies for both dogs, they were both puppies,
0:16:06 > 0:16:10and we insured them, but part of that process was again to go through
0:16:10 > 0:16:13the same questions, that there was nothing wrong with the dogs.
0:16:30 > 0:16:32In this instance, yet again, she told us, yes,
0:16:32 > 0:16:34both dogs were fit and healthy.
0:16:34 > 0:16:38By this point, Agria had gone to great lengths to establish
0:16:38 > 0:16:43that both dogs were in good health, and so the policy was taken out.
0:16:43 > 0:16:46But it wasn't long before they heard from her again.
0:16:47 > 0:16:51The next time we heard from the policyholder was two days later,
0:16:51 > 0:16:53when she rang us and asked for a claim form,
0:16:53 > 0:16:55and she explained that the day before,
0:16:55 > 0:16:58so 9th February, the West Highland white puppy
0:16:58 > 0:17:02had fallen out of her car and damaged one of its hind legs.
0:17:02 > 0:17:05The woman was claiming the accident involving one of the Westie puppies
0:17:05 > 0:17:09happened just one day AFTER taking out the policy.
0:17:09 > 0:17:12Possible, but rather suspicious.
0:17:12 > 0:17:16When the puppy was first presented to the vet, it was limping
0:17:16 > 0:17:18quite badly on one of its back legs.
0:17:18 > 0:17:21The vet examined it and probably diagnosed
0:17:21 > 0:17:26a fairly straightforward strain and suggested that the owner
0:17:26 > 0:17:31didn't walk the dog too aggressively and just rest the dog.
0:17:31 > 0:17:34But it seems a bit of bed rest wouldn't be enough
0:17:34 > 0:17:37to get this pup back on its feet.
0:17:37 > 0:17:41Later that same day, the dog was in front of the vet again,
0:17:41 > 0:17:43and it couldn't put any weight on that leg,
0:17:43 > 0:17:46so the vet X-rayed the puppy and
0:17:46 > 0:17:51an operation followed, because the dog had completely separated
0:17:51 > 0:17:57the stifle joint at the top of the tibia, so a broken leg.
0:17:57 > 0:18:01A nasty injury and a very costly operation.
0:18:01 > 0:18:03In order to make a prompt payment,
0:18:03 > 0:18:07Simon's team were keen to get their paws on the dog's medical records.
0:18:07 > 0:18:11When we receive a claim, as part of our normal checks,
0:18:11 > 0:18:15our normal processes, we start to look at the veterinary history and
0:18:15 > 0:18:20the vet's sequence of events and report on what had happened.
0:18:20 > 0:18:24And at that point, we started to see that perhaps some of the dates
0:18:24 > 0:18:28didn't quite line up with the story the policyholder had told us.
0:18:28 > 0:18:31In fact, her story was starting to look as lame
0:18:31 > 0:18:33as her unfortunate pooch.
0:18:33 > 0:18:36When we delved into the veterinary records
0:18:36 > 0:18:40and we looked at the point at which the policy had been taken out,
0:18:40 > 0:18:44it was very clear that the puppy had damaged itself
0:18:44 > 0:18:48four hours before the policyholder had taken the policy out,
0:18:48 > 0:18:52and two hours before they'd even got a quotation for the policy.
0:18:52 > 0:18:55This is where our claimant's puppy plot starts to unravel.
0:18:55 > 0:18:59She's previously stated the accident happened on 9th February,
0:18:59 > 0:19:02the day after the policy was purchased, but the vet's records
0:19:02 > 0:19:05clearly showed that the injured dog was first examined
0:19:05 > 0:19:11on 8th February, four hours BEFORE the policy ever existed.
0:19:11 > 0:19:15Potentially confusing facts, but a simple truth - the insurance cover
0:19:15 > 0:19:21had been taken out AFTER the dog was injured, making this a false claim.
0:19:21 > 0:19:23Faced with the conflicting dates,
0:19:23 > 0:19:27we wrote to the policyholder and asked her if she could shed
0:19:27 > 0:19:31some light on to the discrepancies between the story she'd told us
0:19:31 > 0:19:34and the history that the vet had supplied to us.
0:19:34 > 0:19:38Once that correspondence was received by the claimant,
0:19:38 > 0:19:43she got straight on the dog-and-bone to Agria's claims team.
0:20:13 > 0:20:16And the claimant had an interesting explanation in response
0:20:16 > 0:20:19to Agria's concerns.
0:20:19 > 0:20:22Her response was that at the time that she saw the vet
0:20:22 > 0:20:25with the puppy, the vet had said there was nothing wrong with the puppy
0:20:25 > 0:20:29and, again, we pointed out that very clearly from the veterinary records
0:20:29 > 0:20:32the dog was limping and the dog wasn't well,
0:20:32 > 0:20:34which is why it had been taken to the vet in the first place.
0:21:04 > 0:21:07Well, the veterinary records clearly stated
0:21:07 > 0:21:09there WAS something wrong with the puppy
0:21:09 > 0:21:11but, crucially, they also showed
0:21:11 > 0:21:13that the claimant had taken the puppy
0:21:13 > 0:21:17to the vet's with a suspected injury before taking out the policy.
0:21:17 > 0:21:21Faced with the discrepancies in the dates, the policyholder
0:21:21 > 0:21:25at that point decided that she would cancel both policies.
0:21:38 > 0:21:40This type of claim never is,
0:21:40 > 0:21:44and she really was barking up the wrong tree with this doggy deceit.
0:21:44 > 0:21:48In this incident, I think we had a policyholder who felt that
0:21:48 > 0:21:50the insurance company would just pay the bill.
0:21:50 > 0:21:52It's very frustrating
0:21:52 > 0:21:56when policyholders think that they can get away with it,
0:21:56 > 0:21:59because the chances are they just don't.
0:22:04 > 0:22:05Now, if you've ever had an accident,
0:22:05 > 0:22:08you may have been contacted by a claims management company
0:22:08 > 0:22:11telling you that you're entitled to compensation and that making
0:22:11 > 0:22:15a personal injury claim is easy and hassle free.
0:22:15 > 0:22:17What they might not tell you is that making
0:22:17 > 0:22:20a false or exaggerated claim is fraud,
0:22:20 > 0:22:23and if your case is found to be bogus in any way,
0:22:23 > 0:22:27then you alone are 100% responsible.
0:22:28 > 0:22:31The days of submitting a cheeky whiplash claim for
0:22:31 > 0:22:35a guaranteed pay-out are long gone, as insurance companies like Esure
0:22:35 > 0:22:40now have a zero-tolerance attitude towards this type of activity.
0:22:40 > 0:22:44Any suspicious claim received by Esure is investigated
0:22:44 > 0:22:48and, if need be, referred to a specialist insurance law firm,
0:22:48 > 0:22:50Horwich Farrelly.
0:22:50 > 0:22:54Partner Ronan McCann recently handled an all-too-common case.
0:22:54 > 0:22:57This was a claim for a personal injury
0:22:57 > 0:22:59as a result of a road traffic accident,
0:22:59 > 0:23:04so roughly £2,000. There was also a claim for vehicle repairs,
0:23:04 > 0:23:07which cost around £500.
0:23:07 > 0:23:11And it was Esure's policyholder who was at fault in one of the
0:23:11 > 0:23:15most everyday accident scenarios on the road.
0:23:15 > 0:23:20The circumstances to this accident was that it was after work.
0:23:20 > 0:23:22The defendant was travelling home.
0:23:22 > 0:23:26In front of him, in very heavy traffic, was a claimant.
0:23:26 > 0:23:29No prizes for guessing where this is going.
0:23:29 > 0:23:33The defendant assumed the claimant was going to move forward
0:23:33 > 0:23:36and he moved off at very low speed.
0:23:36 > 0:23:39Unfortunately, the claimant didn't move,
0:23:39 > 0:23:42and there was a slight kissing of the vehicles.
0:23:43 > 0:23:47And this coming together really was a fleeting peck
0:23:47 > 0:23:48on the claimant's rear end.
0:23:48 > 0:23:51This accident was the most minor of impacts.
0:23:51 > 0:23:55The defendant described it as a "touching of the vehicles".
0:23:55 > 0:23:58The damages to both cars might have been minor,
0:23:58 > 0:24:02but the same couldn't be said for the claimant.
0:24:02 > 0:24:04The allegation from the claimant was that he sustained
0:24:04 > 0:24:08a whiplash-type injury to his neck lasting four months.
0:24:11 > 0:24:15And the claimant's first port of call after the accident
0:24:15 > 0:24:17wasn't where you might expect.
0:24:17 > 0:24:21The chronology after the accident was suspicious.
0:24:21 > 0:24:25The claimant did not first attend upon his GP
0:24:25 > 0:24:27to complain about his injuries
0:24:27 > 0:24:31but instead went first to see solicitors to pursue
0:24:31 > 0:24:33a personal injury claim.
0:24:33 > 0:24:36So it seemed as if the claimant had money on his mind
0:24:36 > 0:24:37rather than his health.
0:24:37 > 0:24:40This immediately rang alarm bells.
0:24:40 > 0:24:43Why would anybody first attend upon solicitors
0:24:43 > 0:24:47to pursue a personal injury claim as opposed to attending
0:24:47 > 0:24:52upon a GP to get their treatment for their injuries?
0:24:52 > 0:24:57Good question, especially when you consider this guy's hobby.
0:24:57 > 0:25:01The claimant, who was a keen amateur kickboxer,
0:25:01 > 0:25:04suggested that he couldn't partake in any sports
0:25:04 > 0:25:08during the period that he was injured.
0:25:08 > 0:25:11Well, that's a given. Or so you'd think.
0:25:11 > 0:25:13But the claimant's bid for compensation was about to take
0:25:13 > 0:25:17a real body blow as Esure did some digging online.
0:25:17 > 0:25:21They were able to find video evidence of the claimant
0:25:21 > 0:25:24fighting in a kickboxing competition
0:25:24 > 0:25:27only five weeks after the accident.
0:25:27 > 0:25:31This showed the claimant taking kicks and punches to the head
0:25:31 > 0:25:34and for Esure, this clearly suggested to them
0:25:34 > 0:25:36that it was a fraudulent claim.
0:25:36 > 0:25:40A quite amazing feat, considering the claimant
0:25:40 > 0:25:43was reportedly suffering with chronic neck pain
0:25:43 > 0:25:45as a result of the accident.
0:25:47 > 0:25:49Only two weeks before the fight,
0:25:49 > 0:25:52the claimant had attended upon a medical legal practitioner
0:25:52 > 0:25:57and described that he was suffering from severe injuries.
0:25:57 > 0:26:01In no way could somebody with severe injuries to the neck
0:26:01 > 0:26:03take part in such a kickboxing fight.
0:26:03 > 0:26:06Well, considering it's one of the most ferocious forms
0:26:06 > 0:26:09of fighting, you'd assume not.
0:26:09 > 0:26:12When the medical records were reviewed,
0:26:12 > 0:26:16it seemed completely inconsistent that the claimant first
0:26:16 > 0:26:22mentioned to the GP initially that his only injuries were to his neck.
0:26:22 > 0:26:26It seemed to us that he invented the suggestion that his head
0:26:26 > 0:26:31and knee injuries were as a result of the road traffic accident.
0:26:31 > 0:26:35Ronan's team had all the evidence they needed to take action.
0:26:35 > 0:26:39As a result, we took the view that we would disclose the video footage
0:26:39 > 0:26:42and invite the claimant to discontinue.
0:26:42 > 0:26:45But instead of throwing in the towel,
0:26:45 > 0:26:50the claimant opted to go toe to toe with Horwich Farrelly in court.
0:26:50 > 0:26:54When this case got to trial, the video footage was crucial.
0:26:54 > 0:26:58When that was considered by the judge against
0:26:58 > 0:27:01the inconsistencies in the chronology, in the evidence,
0:27:01 > 0:27:05the judge could not accept a word that the claimant had said.
0:27:05 > 0:27:08And when it came to deciding a verdict,
0:27:08 > 0:27:10the decision didn't take long.
0:27:10 > 0:27:13The judge dismissed the claimant's case
0:27:13 > 0:27:17and looked at the video evidence and commented that the claimant
0:27:17 > 0:27:19looked perfectly fit and healthy.
0:27:19 > 0:27:23The judge found that the claimant was fundamentally dishonest,
0:27:23 > 0:27:26and was ordered to pay approximately £8,000.
0:27:28 > 0:27:31The kickboxer's claim had hit the canvas
0:27:31 > 0:27:34and he'd ended up with a whopping court bill
0:27:34 > 0:27:36for both solicitors' costs.
0:27:36 > 0:27:41In my view, these individuals are convinced to bring claims
0:27:41 > 0:27:45by accident management companies or claimant solicitors
0:27:45 > 0:27:48who explain to them that they are extremely straightforward.
0:27:48 > 0:27:53The result in this case shows the risks of anyone who believes that.
0:27:53 > 0:27:57Although, the claimant in this case has a significant cost order,
0:27:57 > 0:28:01he was very lucky that he didn't spend some time in prison.
0:28:09 > 0:28:12A woman secretly records her husband in an attempt
0:28:12 > 0:28:15to get the truth about her son's death.
0:28:34 > 0:28:37Insurance cheats often think that just because they've got away
0:28:37 > 0:28:40with it once, they can do it again and again and again.
0:28:40 > 0:28:44Well, they might get away with it once, maybe even twice,
0:28:44 > 0:28:48but in the end, insurers will identify those scammers.
0:28:51 > 0:28:54Collinson Group offers a range of travel services.
0:28:54 > 0:28:57Mathew Crawford-Thomas is their fraud manager, and his speciality
0:28:57 > 0:29:00is dealing with bogus insurance claims.
0:29:00 > 0:29:02He was asked to investigate one case
0:29:02 > 0:29:06from a customer who'd reportedly suffered some tourism trauma.
0:29:06 > 0:29:09We received a claim from our insured
0:29:09 > 0:29:11for a rather harrowing experience that he had
0:29:11 > 0:29:13whilst in a market in Cambodia.
0:29:13 > 0:29:16He'd had over £3,000 worth of valuable items
0:29:16 > 0:29:19stolen from his lap whilst he was on a tuk-tuk.
0:29:19 > 0:29:23The items our insured was claiming for was a rather large
0:29:23 > 0:29:28amount of high-end camera equipment and including an Apple iPad.
0:29:28 > 0:29:33The high-value and location of this claim were instant red flags.
0:29:33 > 0:29:36So Matt used a handy tool at his disposal.
0:29:36 > 0:29:40The insurance fraud investigators' database is full of individuals
0:29:40 > 0:29:43that are either suspected of fraud and/or proven fraud.
0:29:43 > 0:29:47Our insured person did not appear on that database.
0:29:47 > 0:29:51With a seemingly unblemished insurance history,
0:29:51 > 0:29:54Matt's team began processing the claim.
0:29:54 > 0:29:58But then there was an interesting development.
0:29:58 > 0:30:01I happened to have a chance conversation with a fellow
0:30:01 > 0:30:04fraud professional at another insurance company.
0:30:04 > 0:30:07She advised me that she'd also received a claim
0:30:07 > 0:30:10for a similar circumstances for our insured.
0:30:10 > 0:30:13Matt's good fortune would soon turn into hard luck
0:30:13 > 0:30:16for the claimant, as fraud investigators
0:30:16 > 0:30:18don't believe in coincidence.
0:30:18 > 0:30:22After the chance conversation, I ran his details through
0:30:22 > 0:30:25the database again and, lo and behold, I found a match.
0:30:25 > 0:30:29This insurers' resource is continually updated
0:30:29 > 0:30:34and another insurer registered the claimant as a fraud risk shortly
0:30:34 > 0:30:36after Matt had initially checked it.
0:30:36 > 0:30:40After putting my own alert out on an industry-wide database,
0:30:40 > 0:30:45it subsequently transpired that this individual had made 12 claims
0:30:45 > 0:30:47with nine insurers since 2012.
0:30:47 > 0:30:50I then proceeded, under the Data Protection Act,
0:30:50 > 0:30:53to secure the documents to see whether or not
0:30:53 > 0:30:55the items claimed were in fact the same.
0:30:55 > 0:30:59The evidence suggested Matt had a potential serial scammer
0:30:59 > 0:31:03on his hands, which was supported by the next revelation.
0:31:03 > 0:31:07Once we'd received all 12 claims, it transpired
0:31:07 > 0:31:10that this individual had in fact sent the same receipts
0:31:10 > 0:31:15to four different insurance companies over a six-month period.
0:31:15 > 0:31:18The claimant was attempting to repeat the same claim
0:31:18 > 0:31:22for the same items with multiple insurers.
0:31:22 > 0:31:24Eager to get his hands on the cash,
0:31:24 > 0:31:27the claimant was soon back on the phone.
0:31:39 > 0:31:43Nope. Only when claims are suspected to be false,
0:31:43 > 0:31:45and he's right to sound nervous.
0:31:45 > 0:31:48I do believe at this point in time, he was fully aware
0:31:48 > 0:31:51that we were on to him, and other insurers
0:31:51 > 0:31:53were requesting reimbursement of their funds.
0:31:53 > 0:31:57With his claim collapsing, one last call came in.
0:31:59 > 0:32:01The last call from our insured was 20 minutes
0:32:01 > 0:32:04after he had originally rang requesting an update.
0:32:04 > 0:32:07It was in this call that he decided to retract his claim.
0:32:23 > 0:32:25Regardless of the fact that our insured had retracted
0:32:25 > 0:32:28his claim, to me he had still attempted
0:32:28 > 0:32:30to commit fraud by false representation.
0:32:30 > 0:32:34I then made a report into IFED and asked them whether or not they would
0:32:34 > 0:32:36take the case on.
0:32:36 > 0:32:42Officers at the City of London Police's Insurance Fraud Enforcement Department were happy to oblige.
0:32:42 > 0:32:45After lengthy investigations by IFED,
0:32:45 > 0:32:47it was finally referred to the CPS.
0:32:47 > 0:32:50The CPS have decided, due to his previous good character,
0:32:50 > 0:32:53a conditional caution was given, at which point
0:32:53 > 0:32:56he had to repay insurers £18,000.
0:32:56 > 0:32:59To date, all funds have been returned.
0:32:59 > 0:33:01Despite the payment order,
0:33:01 > 0:33:04the claimant was still lucky to avoid further criminal prosecution,
0:33:04 > 0:33:09and with people like Matt on the case, fraudsters beware.
0:33:09 > 0:33:12Anybody that's attempting a fraud of this nature
0:33:12 > 0:33:14want to be careful.
0:33:14 > 0:33:17If they're submitting a claim with my company,
0:33:17 > 0:33:19trust me, I will catch you.
0:33:23 > 0:33:26We've all seen how far UK scammers will go to collect
0:33:26 > 0:33:30an insurance pay-out, but fraudsters are an international problem.
0:33:30 > 0:33:34In fact, our American cousins have it just as bad, with cases
0:33:34 > 0:33:38that will shock you to your very core.
0:33:45 > 0:33:48The rural farming town of Varick in Upstate New York
0:33:48 > 0:33:51was home to the Karlsen family farm.
0:33:52 > 0:33:55In 2008, 23-year-old Levi
0:33:55 > 0:33:58was fixing his father's pick-up truck in the barn
0:33:58 > 0:34:02when something went horribly wrong.
0:34:32 > 0:34:35Tragically, Levi had been killed.
0:34:37 > 0:34:39Father Karl and stepmother Cindy
0:34:39 > 0:34:42had left Levi working alone earlier that day.
0:34:42 > 0:34:47It appeared that he'd been trapped underneath the truck for hours.
0:34:49 > 0:34:52At the time, investigators determined the event
0:34:52 > 0:34:55just to be an awful accident.
0:34:55 > 0:34:58The Karlsens appeared to be a grieving family,
0:34:58 > 0:35:01trying to deal with the tragic loss of their son.
0:35:03 > 0:35:07That was until an anonymous family member contacted the police
0:35:07 > 0:35:10with an unbelievable allegation.
0:35:11 > 0:35:14They claimed Levi's death was no accident
0:35:14 > 0:35:19and that he was the victim of a ruthless insurance fraud
0:35:19 > 0:35:22perpetrated by his own father.
0:35:27 > 0:35:30It was alleged Karl Karlsen had engineered Levi's fatal
0:35:30 > 0:35:34accident in a plot to cash in on his son's life insurance policy.
0:35:34 > 0:35:37As a result of this call,
0:35:37 > 0:35:41the sheriff's office reopened the investigation into Levi's death.
0:35:43 > 0:35:47Investigations revealed that Karl had persuaded Levi to take out
0:35:47 > 0:35:52a life insurance policy worth 700,000 just 17 days
0:35:52 > 0:35:54before his son's death.
0:35:54 > 0:35:58Karl had also convinced Levi not to disclose a serious throat
0:35:58 > 0:36:03condition he suffered from in fear that the policy might be rejected,
0:36:03 > 0:36:07meaning this 700,000 insurance policy
0:36:07 > 0:36:09had been obtained fraudulently.
0:36:12 > 0:36:16Levi was required to have a full physical by his insurers.
0:36:16 > 0:36:19Karlsen knew if the undisclosed condition was discovered,
0:36:19 > 0:36:22the policy would have most likely been voided.
0:36:24 > 0:36:28Levi was due to attend his physical the day after he died.
0:36:31 > 0:36:35Karlsen came under further suspicion as he had also persuaded Levi
0:36:35 > 0:36:38to write a will on the morning of the day he died, making his
0:36:38 > 0:36:42father the sole beneficiary of his life insurance policy.
0:36:42 > 0:36:47Investigators were convinced that this was far more than coincidence
0:36:47 > 0:36:51but as compelling as it was, the evidence was circumstantial.
0:36:51 > 0:36:53They would need further proof.
0:36:53 > 0:36:56So detectives turned to Karl's wife
0:36:56 > 0:36:59and Levi's stepmother, Cindy Karlsen.
0:37:01 > 0:37:05In 2012, Cindy was contacted by investigators.
0:37:05 > 0:37:08To their surprise, she also had growing suspicions
0:37:08 > 0:37:13that Levi's death was no accident. Six months after Levi's death,
0:37:13 > 0:37:18Karlsen received over 700,000 from the life insurance policy.
0:37:18 > 0:37:22Cindy explained how her husband went on a cash-feeding frenzy
0:37:22 > 0:37:24as soon as he had the money.
0:37:24 > 0:37:29Cindy hired a private investigator to dig into her husband's life.
0:37:29 > 0:37:32The PI discovered a terrifying fact.
0:37:34 > 0:37:37Without her knowledge, Karl had taken out various insurance
0:37:37 > 0:37:42policies, which meant that in the event of Cindy's death, Karlsen
0:37:42 > 0:37:45would be the sole beneficiary of assets and pay-outs
0:37:45 > 0:37:48totalling 1.2 million.
0:37:50 > 0:37:52Worried for her own life,
0:37:52 > 0:37:56Cindy left Karlsen and they were officially separated.
0:37:56 > 0:38:00However, Cindy agreed to co-operate with investigators and wear
0:38:00 > 0:38:03a wire in the hope she could record her husband
0:38:03 > 0:38:06confirming suspicions about Levi's death.
0:38:07 > 0:38:10She arranged to meet Karl in a diner under the guise
0:38:10 > 0:38:13of reconciling their marriage.
0:38:34 > 0:38:36Remember, Karl previously claimed
0:38:36 > 0:38:39to have had no knowledge of the accident
0:38:39 > 0:38:43until he returned home with Cindy to find Levi underneath the truck.
0:38:43 > 0:38:48He has just admitted he was present during his death.
0:39:03 > 0:39:07A concerning statement. Karl starts to talk about Levi.
0:39:15 > 0:39:19Cindy then asks Karl about the truck radio being turned on.
0:39:36 > 0:39:39This statement implies the noise of the radio was intended
0:39:39 > 0:39:43to disguise the sound of the truck collapsing on his son,
0:39:43 > 0:39:47suggesting any actions were premeditated.
0:39:48 > 0:39:52The conversation Cindy covertly recorded
0:39:52 > 0:39:55was far from a full confession but Karlsen did admit
0:39:55 > 0:39:59he was there and in fact caused the alleged accident,
0:39:59 > 0:40:01which contradicted everything he'd said to date.
0:40:01 > 0:40:05Investigators now had all they needed to arrest
0:40:05 > 0:40:08and interrogate Karl Karlsen.
0:40:08 > 0:40:11Karlsen was interviewed for over nine hours,
0:40:11 > 0:40:15in which he repeatedly denied planning to kill his son.
0:40:28 > 0:40:31Initially, Karlsen stuck to his original story -
0:40:31 > 0:40:36that he had returned home with his wife and found his son dead.
0:40:36 > 0:40:39He then admits that he was there and, in fact,
0:40:39 > 0:40:42caused the truck to fall on Levi.
0:40:54 > 0:40:58Karlsen maintains this was a genuine accident
0:40:58 > 0:40:59and due to the shock,
0:40:59 > 0:41:03he was overwhelmed and was unable to help his trapped son.
0:41:30 > 0:41:33While Karlsen acknowledged being responsible
0:41:33 > 0:41:36for Levi's death, he was insistent it wasn't
0:41:36 > 0:41:38a deliberate act to kill him.
0:41:38 > 0:41:42Despite this, investigators had enough evidence.
0:41:42 > 0:41:45Karl Karlsen was charged with second-degree murder
0:41:45 > 0:41:47and insurance fraud.
0:41:47 > 0:41:50Karlsen was so anxious to get his hands on the 700,000
0:41:50 > 0:41:54from his son's fraudulently obtained life insurance,
0:41:54 > 0:41:56he'd done the unthinkable.
0:41:56 > 0:41:58In 2013, the case went to court, where,
0:41:58 > 0:42:02faced with the overwhelming evidence against him,
0:42:02 > 0:42:04Karlsen at last told the truth.
0:42:04 > 0:42:07He admitted to intentionally knocking the pick-up truck
0:42:07 > 0:42:12off its jack and leaving his son underneath to die.
0:42:12 > 0:42:14Karl Karlsen pleaded guilty to murder.
0:42:14 > 0:42:16In his closing statement,
0:42:16 > 0:42:19the judge told Karlsen he was not fully human and said,
0:42:19 > 0:42:23"You belong in prison and you belong there until you die."
0:42:23 > 0:42:25Karl Karlsen was sentenced
0:42:25 > 0:42:28to between 15 years and life behind bars
0:42:28 > 0:42:33Karlsen had facilitated a 700,000 insurance fraud
0:42:33 > 0:42:38and murdered his son to make sure he was paid every penny of that money.
0:42:38 > 0:42:42He could now spend the rest of his life behind bars.
0:42:47 > 0:42:50From people chancing their luck by exaggerating their injuries to
0:42:50 > 0:42:55organised criminal gangs, insurance fraud hits all of us in the pocket.
0:42:55 > 0:42:57But instead of getting away with it,
0:42:57 > 0:43:03more and more of these fraudsters are being claimed and shamed.