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.
0:00:26 > 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 > 0:00:35But insurers are fighting back,
0:00:35 > 0:00:39exposing just under 15 fake claims every hour.
0:00:39 > 0:00:41Armed with covert surveillance systems...
0:00:41 > 0:00:44Subject out of the vehicle.
0:00:44 > 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! Stay where you are!
0:00:53 > 0:00:55..they are catching the criminals red-handed.
0:00:55 > 0:00:57Just don't lie to us.
0:00:58 > 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.
0:01:11 > 0:01:15The chilling story of a man involved in a nasty car accident.
0:01:19 > 0:01:23A serving prisoner's phoney claim is easy to unlock.
0:01:23 > 0:01:27It's not often that you're faced with evidence that's this clear
0:01:27 > 0:01:30that someone has entirely fabricated a claim.
0:01:30 > 0:01:34And it's a family affair, as an attempt at insurance fraud
0:01:34 > 0:01:35goes very wrong.
0:01:36 > 0:01:40The claimant in the other vehicle was, in fact, her sister-in-law.
0:01:45 > 0:01:48There are all sorts of different types of vehicles
0:01:48 > 0:01:50on Britain's roads,
0:01:50 > 0:01:54from monstrous haulier's trucks to super-sleek convertibles.
0:01:54 > 0:01:56But no matter what type of vehicle you drive,
0:01:56 > 0:02:01they all have one thing in common - they have to have insurance...
0:02:02 > 0:02:07..which companies like Allianz are more than happy to provide.
0:02:07 > 0:02:10Mihir Pandya heads up their special investigations unit
0:02:10 > 0:02:14and remembers a case involving a very unusual vehicle.
0:02:14 > 0:02:18The case first came to our attention when our policy holder,
0:02:18 > 0:02:22Barry Sandman, contacted our claims team in February 2014,
0:02:22 > 0:02:26where he reported he'd been in a collision with an ice cream van.
0:02:52 > 0:02:54An unfortunate accident.
0:02:54 > 0:02:57I bet Mr Sandman hadn't even wanted an ice cream
0:02:57 > 0:02:59on that wet winter's day.
0:03:25 > 0:03:27It didn't sound like too much damage
0:03:27 > 0:03:29had been caused to the ice cream van,
0:03:29 > 0:03:33so Mihir and his team were a bit shocked when the bill came in.
0:03:36 > 0:03:39We received an invoice
0:03:39 > 0:03:40for the repairs
0:03:40 > 0:03:43to the ice cream van, subsequently,
0:03:43 > 0:03:45from the purported owner,
0:03:45 > 0:03:48where it showed that the damage was in the region of £24,000.
0:03:48 > 0:03:51We had concerns almost immediately.
0:03:51 > 0:03:56Where normally we would expect company-headed paper,
0:03:56 > 0:03:58we would expect a little bit more detail,
0:03:58 > 0:04:02and whilst there were details of a company on the invoice,
0:04:02 > 0:04:07it didn't really seem that it was a professionally-created invoice.
0:04:08 > 0:04:10With concerns that this may be a false claim,
0:04:10 > 0:04:12Allianz decided to dig deeper.
0:04:14 > 0:04:18Because of the extent of the damage to the ice cream van,
0:04:18 > 0:04:19we instructed a motor engineer.
0:04:21 > 0:04:24And on inspecting the vehicle, he realised very quickly
0:04:24 > 0:04:26that he'd already inspected that ice cream van
0:04:26 > 0:04:29for another insurer previously, with the same damage.
0:04:30 > 0:04:32We contacted the other insurer.
0:04:32 > 0:04:35The claim that they'd received was identical
0:04:35 > 0:04:37to the one that we had on our books.
0:04:37 > 0:04:39More enquiries revealed that, in fact,
0:04:39 > 0:04:41the ice cream van had also been used
0:04:41 > 0:04:44for a third accident with the same damage.
0:04:47 > 0:04:51The insurance companies all swapped evidence and it was clear that they
0:04:51 > 0:04:55were all being targeted by the same ice cream van fraudster.
0:04:57 > 0:05:02Had the three claims been paid by the three insurance companies,
0:05:02 > 0:05:06that would have exceeded £100,000.
0:05:07 > 0:05:11Mihir was convinced he'd uncovered an attempt to defraud
0:05:11 > 0:05:12on a large scale.
0:05:12 > 0:05:14So, he contacted the City of London Police's
0:05:14 > 0:05:17dedicated Insurance Fraud Enforcement Department.
0:05:19 > 0:05:21Since they were set up in 2012,
0:05:21 > 0:05:26IFED have secured over 120 years-worth of custodial sentences
0:05:26 > 0:05:28for convicted insurance fraudsters.
0:05:31 > 0:05:36IFED took up the investigation and started to make their own enquiries.
0:05:36 > 0:05:39During this time, around April 2014,
0:05:39 > 0:05:42we were then, completely out of the blue,
0:05:42 > 0:05:44contacted by another individual,
0:05:44 > 0:05:47who told us that he'd been involved with an accident
0:05:47 > 0:05:50with Mr Sandman some months prior.
0:05:50 > 0:05:54We looked into this and it turned out that the date of this
0:05:54 > 0:05:57accident was the same day as Mr Sandman had taken
0:05:57 > 0:05:59a policy out with Allianz Insurance.
0:05:59 > 0:06:04It seemed very convenient that Mr Sandman had had an accident
0:06:04 > 0:06:07on the very same day he'd started a motor insurance policy.
0:06:08 > 0:06:11We contacted Mr Sandman,
0:06:11 > 0:06:14asked him why he never reported the incident to us,
0:06:14 > 0:06:16and he didn't really have an answer to that.
0:06:17 > 0:06:20He then provided details of the accident,
0:06:20 > 0:06:24saying it happened a couple of hours after he'd taken the policy out,
0:06:24 > 0:06:27but we knew that this was a lie.
0:06:27 > 0:06:31The person whose car was damaged provided us with photographs
0:06:31 > 0:06:35and images of the damage, which was time stamped,
0:06:35 > 0:06:38and it was clear that that accident, whilst we believed did happen,
0:06:38 > 0:06:42happened before the policy was incepted with us.
0:06:43 > 0:06:46Mr Sandman had been caught out.
0:06:46 > 0:06:48He had taken out his vehicle insurance cover
0:06:48 > 0:06:51just hours after causing an accident.
0:06:51 > 0:06:55Then, months later, in a separate incident with an innocent motorist,
0:06:55 > 0:06:58he had lied about colliding with an ice cream van.
0:06:59 > 0:07:02IFED arrested him and the case went to trial.
0:07:03 > 0:07:08In April 2016, Mr Sandman pleaded guilty to two counts -
0:07:08 > 0:07:11one count of conspiracy to defraud,
0:07:11 > 0:07:13which was in relation to the ice cream van,
0:07:13 > 0:07:16and another fraud by false representation,
0:07:16 > 0:07:18and that was for the second claim.
0:07:18 > 0:07:22Mr Sandman was given a 12-month custodial sentence,
0:07:22 > 0:07:23suspended for two years,
0:07:23 > 0:07:27and ordered to undertake 180 hours of unpaid labour.
0:07:29 > 0:07:32Allianz were satisfied that their policyholder, Mr Sandman,
0:07:32 > 0:07:34had been given his just deserts.
0:07:36 > 0:07:40However, for IFED, the mystery of the ice cream van still remained.
0:07:42 > 0:07:46The same van had appeared in three separate insurance claims,
0:07:46 > 0:07:48with three different insurance companies.
0:07:48 > 0:07:53Each time a claim was put in for the same damage to the van's side.
0:07:53 > 0:07:57The three alleged accidents had happened in random locations
0:07:57 > 0:08:03across the UK - one in Kent, one in Bristol and one in Burnley.
0:08:03 > 0:08:05IFED detective Paula Doyle has worked on the case
0:08:05 > 0:08:09since it was referred over from Allianz.
0:08:09 > 0:08:11What we actually thought was happening was
0:08:11 > 0:08:14there was an organised crime group behind this fraud.
0:08:16 > 0:08:19Clearly, a lot of people are concerned, because it's happened
0:08:19 > 0:08:24over a large geographical area and, clearly, very organised individuals.
0:08:24 > 0:08:28There was one fact IFED were 100% sure about -
0:08:28 > 0:08:31there was only ever one ice cream van.
0:08:31 > 0:08:34It was the same colour, the damage was the same,
0:08:34 > 0:08:37it had the same stock inside,
0:08:37 > 0:08:42it even had the same mileage on the speedometer.
0:08:42 > 0:08:46The fact that the mileage was the same demonstrates
0:08:46 > 0:08:48that these people are transporting a van,
0:08:48 > 0:08:51probably on the back of a pick-up truck...
0:08:52 > 0:08:54..without it ever having been driven.
0:08:55 > 0:08:58But the ice cream van did have different number plates on it
0:08:58 > 0:09:00each time a claim was put in.
0:09:00 > 0:09:03It's easy to trace an owner, once you have a number plate.
0:09:03 > 0:09:05Or, at least, it should be.
0:09:06 > 0:09:11We found out that they were in fake names, at different addresses.
0:09:12 > 0:09:16They weren't insured, so we couldn't trace the individuals.
0:09:16 > 0:09:18At this point in their investigation,
0:09:18 > 0:09:22IFED turned their attention back to Mr Sandman.
0:09:22 > 0:09:24He'd obviously been, somehow, persuaded by the gang to say
0:09:24 > 0:09:27he'd crashed his car into the ice cream van.
0:09:27 > 0:09:31He must know the owners and be able to identify them.
0:09:31 > 0:09:34They questioned him at the station, and the interview was recorded.
0:10:10 > 0:10:14They were clearly not going to get any lead from Mr Sandman.
0:10:14 > 0:10:16For whatever reason, perhaps fear,
0:10:16 > 0:10:19he wasn't about to give the police information
0:10:19 > 0:10:21about the ice cream van gang.
0:10:21 > 0:10:24IFED had hit a wall in their investigation.
0:10:24 > 0:10:28The gang had been clever, but not that clever.
0:10:28 > 0:10:30They'd only been paid by one insurance company
0:10:30 > 0:10:32for the damage to the ice cream van
0:10:32 > 0:10:36before the link was made and fraud identified.
0:10:36 > 0:10:38The other two companies never paid a penny.
0:10:40 > 0:10:44I'd say that the fraud was quite well-planned.
0:10:44 > 0:10:47Perhaps not the best thought-out fraud, however,
0:10:47 > 0:10:50because I think these fraudsters forgot
0:10:50 > 0:10:52if you've got a bright pink ice cream van
0:10:52 > 0:10:54with a hole in the side,
0:10:54 > 0:10:57somebody somewhere is going to recognise it.
0:10:57 > 0:11:02For IFED, the case of the ice cream van gang is far from frozen.
0:11:02 > 0:11:04The hunt for the criminals continues
0:11:04 > 0:11:07and they'll stop at nothing to see them behind bars.
0:11:12 > 0:11:17A man's expensive tastes leads to his undoing.
0:11:17 > 0:11:20He must've had a lot of room service. That's all I'll say.
0:11:20 > 0:11:25And an insurance company cries foul, when a footballer attempts to score
0:11:25 > 0:11:26with a claim.
0:11:26 > 0:11:29He also played against a rival during that four-week period,
0:11:29 > 0:11:30in which he scored a goal.
0:11:37 > 0:11:40When insurance fraud is committed against large, private companies,
0:11:40 > 0:11:44it's important there are systems in place to detect it and stamp it out.
0:11:44 > 0:11:48Otherwise, it's ultimately the customers that pay the price.
0:11:48 > 0:11:52However, when a fraudulent attack is made on a state-run system,
0:11:52 > 0:11:55it's arguably even more important that it's discovered
0:11:55 > 0:11:58and stopped before any money is paid out
0:11:58 > 0:12:01to avoid a situation where taxpayers -
0:12:01 > 0:12:03that's you and I - are funding fraud.
0:12:06 > 0:12:09Foston Hall in Derbyshire is a women's only prison.
0:12:11 > 0:12:14Joanne Riley, a litigation specialist at the prison,
0:12:14 > 0:12:16recalls a case where one of the prisoners
0:12:16 > 0:12:17put in a personal injury claim.
0:12:19 > 0:12:21The initial claim was for an accident
0:12:21 > 0:12:24that she alleged happened in her cell on D Wing.
0:12:24 > 0:12:27She alleged that she was moving a cupboard with a cellmate
0:12:27 > 0:12:29and, whilst moving the cupboard,
0:12:29 > 0:12:34the uneven floor made the cupboard fall and it injured her face.
0:12:34 > 0:12:37Her alleged injuries were quite minor. It was nothing
0:12:37 > 0:12:41that required any hospitalisation or any time to see a doctor.
0:12:41 > 0:12:44Even so, prisons have a responsibility
0:12:44 > 0:12:46for the wellbeing of their prisoners
0:12:46 > 0:12:50and, with an uneven floor being cited as the cause of the accident,
0:12:50 > 0:12:52Foston Hall could well have been liable.
0:12:52 > 0:12:55As with all such claims,
0:12:55 > 0:12:58they began to investigate thoroughly before paying out.
0:12:58 > 0:13:01There didn't seem to be any reason why there would be any problem.
0:13:01 > 0:13:03It was only, in further investigation,
0:13:03 > 0:13:06when I looked to see if there was any reports
0:13:06 > 0:13:09that the floor was uneven that I discovered there was nothing
0:13:09 > 0:13:10logged anywhere with the maintenance
0:13:10 > 0:13:13department to say there had been any problems at any time with
0:13:13 > 0:13:16the flooring on the D Wing room that she was located in.
0:13:16 > 0:13:21By now, the prison's solicitors had officially started legal proceedings
0:13:21 > 0:13:23against Foston Hall.
0:13:24 > 0:13:28However, suspicious that the claim wasn't entirely genuine,
0:13:28 > 0:13:32Joanne encouraged her supervisor, Carl Davis, to investigate further.
0:13:34 > 0:13:38Carl's first port of call was to examine a book called a wing diary.
0:13:38 > 0:13:40It is used by staff to record
0:13:40 > 0:13:42everything that happens at the prison.
0:13:42 > 0:13:45And it immediately revealed an inconsistency.
0:13:48 > 0:13:50The claimant had reported to staff she'd received injuries
0:13:50 > 0:13:52on the 24th of October.
0:13:52 > 0:13:56The staff had reported that to our healthcare department,
0:13:56 > 0:14:00and they had made notes in the wing diary, to that effect.
0:14:00 > 0:14:03When we received notification from the claimant's solicitors,
0:14:03 > 0:14:06the claimant's solicitors were alleging that the incident
0:14:06 > 0:14:09actually took place on the 31st of October.
0:14:09 > 0:14:11That gave us some concern.
0:14:12 > 0:14:15It wasn't looking good for the prisoner's claim.
0:14:15 > 0:14:17However, nothing could have prepared Carl and his team
0:14:17 > 0:14:20for what they found next.
0:14:20 > 0:14:24At Foston Hall, all phone calls made by the prisoners are recorded.
0:14:24 > 0:14:26So, staff at the prison looked through the transcript
0:14:26 > 0:14:30from the phone calls this prisoner had made. And one stood out.
0:14:30 > 0:14:32It was to her father,
0:14:32 > 0:14:36and they immediately passed on their findings to Carl.
0:14:36 > 0:14:40The claimant was clearly heard to state that she had not received
0:14:40 > 0:14:43the injuries as a result of an accident moving furniture,
0:14:43 > 0:14:46but she had received the injuries, as a result of a fight
0:14:46 > 0:14:48with another prisoner.
0:14:48 > 0:14:49During that telephone call,
0:14:49 > 0:14:53the claimant conspired with her father
0:14:53 > 0:14:57to ask the father to contact his solicitors, on her behalf,
0:14:57 > 0:15:00so she could commence making a claim
0:15:00 > 0:15:02against the prison service for injuries,
0:15:02 > 0:15:07which clearly had not happened in the way she was describing.
0:15:07 > 0:15:08They had the proof they needed,
0:15:08 > 0:15:10that this inmate had made up
0:15:10 > 0:15:13the whole story of how she'd got her injuries.
0:15:13 > 0:15:15They gathered together all the evidence they found
0:15:15 > 0:15:20and handed it over to the GLD, the government's legal department.
0:15:20 > 0:15:23Henry Ripley, a deputy director at GLD,
0:15:23 > 0:15:26knew he had a strong case on his hands.
0:15:27 > 0:15:29So, the telephone recording revealed
0:15:29 > 0:15:31that she'd been in a fight with a prisoner,
0:15:31 > 0:15:33that she had sustained injuries
0:15:33 > 0:15:36and, ultimately, that she was looking to pin those injuries
0:15:36 > 0:15:37on the prison
0:15:37 > 0:15:40by bringing a claim that really had no basis whatsoever,
0:15:40 > 0:15:43simply in the hope of securing some compensation.
0:15:43 > 0:15:47It's not often that you are faced with evidence that is this clear,
0:15:47 > 0:15:50that someone has entirely fabricated a claim,
0:15:50 > 0:15:54so our reaction was one of surprise.
0:15:54 > 0:15:58Ultimately, we took the decision very quickly this had to be evidence
0:15:58 > 0:16:00which would firmly back up our position
0:16:00 > 0:16:02and enable us to defend the claim.
0:16:02 > 0:16:05And therefore, the step we took next was to alert
0:16:05 > 0:16:08the claimant's solicitors to this crucial piece of evidence,
0:16:08 > 0:16:10with a view to this claim proceeding no further.
0:16:10 > 0:16:13What happened next came as no surprise.
0:16:13 > 0:16:16As a result of the evidence we put to the claimant's solicitors,
0:16:16 > 0:16:18she took the right decision.
0:16:18 > 0:16:20She didn't proceed with her claim and, as a result,
0:16:20 > 0:16:22the public purse was saved from paying compensation
0:16:22 > 0:16:24on a wrongful basis.
0:16:24 > 0:16:26The last thing taxpayers want to see -
0:16:26 > 0:16:28public money spent on compensating
0:16:28 > 0:16:30prisoners for claims that aren't justified.
0:16:30 > 0:16:33And so this provides a really positive message
0:16:33 > 0:16:35to the wider public that such claims are being taken seriously,
0:16:35 > 0:16:38investigated properly and action taken, where dubious claims
0:16:38 > 0:16:41are being brought.
0:16:45 > 0:16:48Now, unlike most other types of insurance,
0:16:48 > 0:16:50car insurance isn't optional.
0:16:50 > 0:16:54If you're driving on UK roads, the law says you've got to have it.
0:16:54 > 0:16:56If you are caught without car insurance,
0:16:56 > 0:16:57you can be banned from driving,
0:16:57 > 0:17:01fined and even have your car seized and crushed.
0:17:01 > 0:17:03Ouch.
0:17:05 > 0:17:08So, I would say it makes sense to buy car insurance.
0:17:10 > 0:17:14LV supply motor policies to drivers up and down the country.
0:17:16 > 0:17:19Simon Rylands is their crimes prevention manager,
0:17:19 > 0:17:22so is always on the lookout for fraudulent activity.
0:17:23 > 0:17:28He recalls a case which at first glance appeared to be totally legit.
0:17:28 > 0:17:31Our customer contacted us to report she'd been involved in a accident
0:17:31 > 0:17:35where she pulled out of a side road and hit the side of another vehicle.
0:17:35 > 0:17:39LV's customer took responsibility for this nasty accident,
0:17:39 > 0:17:43which resulted in both cars being written off.
0:17:43 > 0:17:48LV quickly paid out £2,500 to their customer for her car.
0:17:48 > 0:17:51But more demands for money soon arrived.
0:17:51 > 0:17:53We also received a claim from the other driver
0:17:53 > 0:17:56for the total loss value of his vehicle.
0:17:56 > 0:18:01Hire costs, personal injury claim and some other expenses.
0:18:01 > 0:18:05Total value of his claim was around £8,500.
0:18:05 > 0:18:08And we also had a claim from a passenger in his vehicle,
0:18:08 > 0:18:11which was valued at around £5,000.
0:18:11 > 0:18:15So, a total of £16,000 worth of claims.
0:18:15 > 0:18:18A not unreasonable sum, considering the extent of the accident.
0:18:18 > 0:18:22However, a routine investigation raised a red flag.
0:18:22 > 0:18:27Our systems indicated to us that a company that featured on the claim,
0:18:27 > 0:18:30they'd been involved in a previous suspect claim with LV.
0:18:30 > 0:18:33At that point, we wanted to look into it a bit further
0:18:33 > 0:18:36and see if there was anything suspicious about this claim.
0:18:36 > 0:18:38They received statements from all three people involved
0:18:38 > 0:18:40in the accident -
0:18:40 > 0:18:44their own customer, plus the driver and passenger of the car she hit.
0:18:44 > 0:18:47We discovered there were inconsistencies between statements.
0:18:47 > 0:18:51Our customer said the other driver drove away from the scene,
0:18:51 > 0:18:56whereas he told us that his vehicle required recovery from the scene.
0:18:56 > 0:18:58We'd really expect our customer to be able to remember
0:18:58 > 0:19:01whether the other car did drive away from the scene,
0:19:01 > 0:19:04or whether, in fact, a recovery truck came.
0:19:04 > 0:19:08However, one thing that everybody did agree was that LV's policyholder
0:19:08 > 0:19:09was a complete stranger
0:19:09 > 0:19:12to the two people in the car she collided into.
0:19:14 > 0:19:17Simon and his team proved this to be a lie.
0:19:18 > 0:19:20Our customer was connected to the address for the passenger
0:19:20 > 0:19:22in the other vehicle by the fact
0:19:22 > 0:19:25that her mother lived at this address, also.
0:19:25 > 0:19:27This suggested there was a clear family link
0:19:27 > 0:19:30between our customer and the passenger in the other vehicle.
0:19:30 > 0:19:34LV went back to their customer with the evidence that proved that one
0:19:34 > 0:19:36of the people she had crashed into
0:19:36 > 0:19:38just happened to live with her own mother.
0:19:38 > 0:19:41Although she wouldn't provide a formal statement to us,
0:19:41 > 0:19:45the claimant in the other vehicle was in fact her sister-in-law.
0:19:46 > 0:19:49You'd think LV's customer might have remembered sooner that one
0:19:49 > 0:19:54of the people she crashed into was a member of her own family.
0:19:54 > 0:19:57LV had heard enough.
0:19:57 > 0:19:59In view of our suspicions about the claim,
0:19:59 > 0:20:02we made no payments to the third-party driver.
0:20:02 > 0:20:05So, his solicitors then issued legal proceedings.
0:20:05 > 0:20:08That would mean that his solicitors will be taking the case to trial
0:20:08 > 0:20:10and a judge would hear all the evidence.
0:20:12 > 0:20:15Perhaps the driver thought that LV would back down and just pay out,
0:20:15 > 0:20:18rather than face expensive legal costs.
0:20:18 > 0:20:21But they didn't and the case went to court.
0:20:21 > 0:20:25The outcome of the trial was that the judge was entirely satisfied
0:20:25 > 0:20:27that the claim was fraudulent.
0:20:27 > 0:20:30And that the accident didn't happen, but if it did, that it was staged.
0:20:30 > 0:20:34The judge dismissed the claim and he ordered the claimant to repay LV
0:20:34 > 0:20:37£53,000 in costs.
0:20:37 > 0:20:41These three people clearly knew each other and were even related.
0:20:41 > 0:20:44With a fine of over 50 grand to pay,
0:20:44 > 0:20:48I bet the next family meal was an interesting one, to say the least.
0:20:56 > 0:21:01An evil woman puts a 1 million price tag on her husband's life.
0:21:16 > 0:21:20Travelling to far-flung corners of the world is now more possible
0:21:20 > 0:21:23than ever, whether you're heading for the plains of the Serengeti
0:21:23 > 0:21:25or the lava fields of Iceland.
0:21:25 > 0:21:29But, of course, your dream holiday you'd been looking forward to
0:21:29 > 0:21:32can quickly become one you would much rather forget,
0:21:32 > 0:21:35if you have an accident or are the victim of a crime.
0:21:38 > 0:21:41You can never be prepared for every eventuality,
0:21:41 > 0:21:43but companies like CEGA provide travel insurance,
0:21:43 > 0:21:47to help out if something awful does happen whilst you're overseas.
0:21:47 > 0:21:50Simon Cook, head of special investigations,
0:21:50 > 0:21:52remembers a particularly horrific ordeal
0:21:52 > 0:21:56involving a man who was visiting Tanzania.
0:21:56 > 0:22:01The customer contacted our medical emergency helpline,
0:22:01 > 0:22:04to tell us he had been involved in an armed robbery, unfortunately.
0:22:04 > 0:22:07He had also told us that he had his personal possessions stolen
0:22:07 > 0:22:08in the robbery.
0:22:08 > 0:22:12It must be one of the most frightening things imaginable,
0:22:12 > 0:22:15to be held up at gunpoint. And, what's more,
0:22:15 > 0:22:17the armed robber had physically assaulted the man.
0:22:19 > 0:22:21It sounded like a very violent attack,
0:22:21 > 0:22:24because the customer was an in-patient in hospital
0:22:24 > 0:22:27for two weeks, so he must have been badly injured.
0:22:33 > 0:22:37The man was claiming £1,000 for his stolen possessions
0:22:37 > 0:22:40and £6,000 for his hospital bills.
0:22:40 > 0:22:44Simon and his team are experts in international medical provision and,
0:22:44 > 0:22:48to them, this seemed expensive for a Tanzanian hospital.
0:22:48 > 0:22:51They waited for the paperwork to arrive.
0:22:51 > 0:22:55The customer only provided three documents for a two-week stay
0:22:55 > 0:22:58in hospital. This just seems a little unusual.
0:22:58 > 0:23:01You would expect to see a lot more documents than that.
0:23:02 > 0:23:06They decided to investigate further and, as standard procedure,
0:23:06 > 0:23:08they contacted the man, to ask him to sign a form,
0:23:08 > 0:23:12giving them permission to examine his claim in more detail.
0:23:12 > 0:23:17The customer duly signed the form, but we were concerned to note that,
0:23:17 > 0:23:20when he sent the form back to us, he stated in writing that he had now
0:23:20 > 0:23:23appointed a solicitor to deal with this matter.
0:23:23 > 0:23:27It is very unusual for a customer making a genuine claim
0:23:27 > 0:23:30to make threats of legal action.
0:23:30 > 0:23:33At this point, we were even more concerned with the claim
0:23:33 > 0:23:35that was presented to us.
0:23:36 > 0:23:39When Simon and his team have doubts over a customer's claim,
0:23:39 > 0:23:42they will conduct a full investigation.
0:23:42 > 0:23:44And distance is no barrier.
0:23:44 > 0:23:47Due to our concerns with the claim, we decided to appoint
0:23:47 > 0:23:51our on-the-ground investigator in Tanzania,
0:23:51 > 0:23:53just to ensure that the claim presented was, in fact,
0:23:53 > 0:23:56valid and covered by the terms and conditions of the policy.
0:23:58 > 0:24:01Yeah, they've got on-the-ground agents everywhere.
0:24:01 > 0:24:02And this one wasted no time.
0:24:02 > 0:24:04He headed straight to the hospital,
0:24:04 > 0:24:07where the customer had been laid up for two weeks.
0:24:09 > 0:24:13The first thing that he noted was that the hospital doesn't deal
0:24:13 > 0:24:16in US dollars, which was the currency that the customer
0:24:16 > 0:24:17had claimed he'd paid the hospital in.
0:24:19 > 0:24:22Further investigations with the hospital staff revealed that
0:24:22 > 0:24:26the customer's name was not listed anywhere in their official records
0:24:26 > 0:24:29and that he hadn't actually been treated there.
0:24:29 > 0:24:33So, he'd never even been inside the hospital.
0:24:33 > 0:24:35The agent was going great guns.
0:24:35 > 0:24:38Next, he headed to a hotel where the customer had stayed
0:24:38 > 0:24:42and later submitted the bill to CEGA, as part of his claim.
0:24:42 > 0:24:47We established that the hotel charge a maximum of 35 per night,
0:24:47 > 0:24:50which was obviously concerning for us because the customer
0:24:50 > 0:24:52had paid 135 per night.
0:24:53 > 0:24:56He must have had a lot of room service -
0:24:56 > 0:24:57that's all I would say on that.
0:24:57 > 0:25:00However, it did seem that, at least, this time,
0:25:00 > 0:25:04the customer had connections with the hotel.
0:25:04 > 0:25:06When we questioned the hotel manager,
0:25:06 > 0:25:10we actually established that he was good friends with our customer,
0:25:10 > 0:25:14but he then proceeded to tell us that the customer had provided us
0:25:14 > 0:25:17with a fraudulent invoice and he didn't actually stay at the hotel.
0:25:17 > 0:25:19Who needs friends(?)
0:25:19 > 0:25:23I bet that particular friend is off the Christmas card list.
0:25:24 > 0:25:26The Tanzania agent had one final place to go.
0:25:27 > 0:25:30We then proceeded to visit the police station.
0:25:30 > 0:25:33We spoke to one of the officers there who immediately told us that
0:25:33 > 0:25:37the crime reference number provided on the report wasn't in the same
0:25:37 > 0:25:39format as their genuine crime numbers.
0:25:39 > 0:25:43Further to this, the police officer that we spoke with said the person
0:25:43 > 0:25:47allegedly who signed the police report didn't, in fact, work at
0:25:47 > 0:25:50the police station and they don't even have a lieutenant as a rank
0:25:50 > 0:25:52within that station.
0:25:52 > 0:25:56As far as CEGA was concerned, it was case closed.
0:25:57 > 0:26:00Armed with the evidence that we have obtained through
0:26:00 > 0:26:04our overseas investigation, we contacted the customer by telephone,
0:26:04 > 0:26:08to give him the opportunity to be open and honest with us
0:26:08 > 0:26:09about the actual claim.
0:26:09 > 0:26:14Unsurprisingly, the customer said he had nothing further to add
0:26:14 > 0:26:16to the situation and he was making a genuine claim.
0:26:16 > 0:26:21However, the on-the-ground work done by their agent had provided
0:26:21 > 0:26:23irrefutable proof to the contrary.
0:26:25 > 0:26:28It was entirely evident from our investigation that the claim
0:26:28 > 0:26:30was completely fraudulent.
0:26:30 > 0:26:32We weren't satisfied that any aspect of it was genuine.
0:26:32 > 0:26:37As far as we are concerned, the armed robbery simply didn't occur.
0:26:37 > 0:26:41Simon and his team stuck to their guns and refused to pay out a penny.
0:26:41 > 0:26:44They never heard from their customer again.
0:26:53 > 0:26:56Now, on this show, we look at lots of examples
0:26:56 > 0:26:58of people committing insurance fraud.
0:26:58 > 0:27:00With individual claims, more often than not,
0:27:00 > 0:27:02there is some truth behind the incident.
0:27:02 > 0:27:06Say, a bag was stolen, but the contents are a little exaggerated.
0:27:06 > 0:27:09Or an accident at work did happen, but the employee
0:27:09 > 0:27:12wasn't as badly hurt as he maintained.
0:27:12 > 0:27:13It's all fraud and it is all illegal,
0:27:13 > 0:27:17but at least there was some grains of truth to the story.
0:27:17 > 0:27:21Well, the next case we're going to look at involved lies so blatant,
0:27:21 > 0:27:24and told without a care for the consequences,
0:27:24 > 0:27:26that one of the highest legal offices in the land
0:27:26 > 0:27:29felt it necessary to intervene.
0:27:30 > 0:27:34Richard Hiscocks works at Aviva, as their Director of Casualty Claims.
0:27:34 > 0:27:36Back in October 2013,
0:27:36 > 0:27:39a member of the team received a call to say that one of their
0:27:39 > 0:27:41policyholders had caused a minor accident.
0:27:43 > 0:27:47So, we first became aware of this case when our insured
0:27:47 > 0:27:51had reversed into the claimant in a fast-food restaurant
0:27:51 > 0:27:54drive-through. They'd overshot the place where you speak your order
0:27:54 > 0:27:59into the microphone, reversed up gently and nudged the car behind,
0:27:59 > 0:28:01which was driven by Gary Burnett, the claimant,
0:28:01 > 0:28:05who then claimed that he had shoulder and neck injuries,
0:28:05 > 0:28:08which prevented him from fulfilling his normal life.
0:28:08 > 0:28:12Gary Burnett was claiming £2,000 for his whiplash injuries,
0:28:12 > 0:28:16but, from the word go, his story of the accident at the drive-through
0:28:16 > 0:28:19left a bad taste in the mouth.
0:28:20 > 0:28:23We were immediately suspicious because this is what we call
0:28:23 > 0:28:28a low-speed impact. Our customer had told us that the speed at which
0:28:28 > 0:28:31he was reversing was very slight. The vehicle damage supported that
0:28:31 > 0:28:34and, actually, it is most unusual to get injury when the speed
0:28:34 > 0:28:36of the impact is so slight.
0:28:36 > 0:28:40They had photos from their insured driver that showed how little damage
0:28:40 > 0:28:43there was to either vehicle.
0:28:43 > 0:28:45We decided that, in the light of this evidence,
0:28:45 > 0:28:49the claim was spurious and we have a duty, in that case,
0:28:49 > 0:28:53to defend our customers. And, so, we decided we weren't going to pay
0:28:53 > 0:28:57this claim. He then proceeded to litigate against us,
0:28:57 > 0:29:01which meant the claim went to trial, for him to prove that he was injured
0:29:01 > 0:29:04and that we should have been paying him compensation.
0:29:04 > 0:29:07Aviva enlisted their solicitors, Horwich Farrelly,
0:29:07 > 0:29:09to fight the litigation against them.
0:29:09 > 0:29:11David Scott represented them.
0:29:11 > 0:29:14So, when Horwich Farrelly got the case,
0:29:14 > 0:29:18we looked at the evidence presented by the insured driver,
0:29:18 > 0:29:21which were some very good photographs taken at the scene,
0:29:21 > 0:29:23which show virtually no damage to either of the cars.
0:29:23 > 0:29:25We also spoke in detail to the insured driver,
0:29:25 > 0:29:29who told us that this was a very, very minor accident.
0:29:29 > 0:29:33He reversed back a small distance into very, very minor contact with
0:29:33 > 0:29:36the front of the claimant's car. So, based on that, we decided
0:29:36 > 0:29:37to investigate this further,
0:29:37 > 0:29:41as we believed it to be a potentially dishonest claim.
0:29:41 > 0:29:44Gary Burnett made his living as a window cleaner
0:29:44 > 0:29:47and also played football semi-professionally.
0:29:47 > 0:29:50He maintained that his injuries were affecting his ability
0:29:50 > 0:29:51to earn a living.
0:29:52 > 0:29:54The claimant had told his medical expert
0:29:54 > 0:29:57that the whiplash injuries were pretty severe.
0:29:57 > 0:30:00So they caused him to have time off work as a window cleaner
0:30:00 > 0:30:03and they also stopped him from playing football.
0:30:03 > 0:30:05He went on to say, in an official legal statement,
0:30:05 > 0:30:09that he hadn't been able to train or play for a whole month.
0:30:09 > 0:30:12But, unfortunately, for Burnett, a social media search revealed
0:30:12 > 0:30:15that this was a total lie.
0:30:15 > 0:30:19The Twitter account of the claimant was one that was publicly available
0:30:19 > 0:30:23and showed the claimant had played football during this
0:30:23 > 0:30:26four-week period that he said he couldn't play at all.
0:30:26 > 0:30:28# Here we go, here we go, here we go
0:30:28 > 0:30:30# Here we go, here we go Here we go-o... #
0:30:30 > 0:30:34It showed he played against Kendal Town the day after the accident.
0:30:34 > 0:30:36# Here we go, here we go! #
0:30:36 > 0:30:40He'd also played against a rival during that four-week period,
0:30:40 > 0:30:41in which he had scored a goal.
0:30:41 > 0:30:43# Here we go, here we go, here we go
0:30:43 > 0:30:45# Here we go, here we go, here we go
0:30:45 > 0:30:47# Here we go, here we go! #
0:30:47 > 0:30:51He was very proud of his achievements.
0:30:54 > 0:30:57Those tweets were to be a game changer.
0:30:57 > 0:30:59FULL-TIME WHISTLE
0:30:59 > 0:31:04They proved undisputedly what Aviva and Horwich Farrelly
0:31:04 > 0:31:08had suspected all along. Gary Burnett had, in no way,
0:31:08 > 0:31:11been injured as a result of the collision at the drive-through.
0:31:14 > 0:31:16Once we'd completed our investigations,
0:31:16 > 0:31:20we served all of this evidence on the claimant's solicitors.
0:31:20 > 0:31:23On receiving that, the claimant abandoned his claim.
0:31:23 > 0:31:26He discontinued his claim completely and wanted to walk away.
0:31:26 > 0:31:30We reviewed the case with Aviva and we were happy we had enough evidence
0:31:30 > 0:31:33that - in fact, significant evidence - to show this was
0:31:33 > 0:31:35a dishonest claim, so we decided to take it on and take this case
0:31:35 > 0:31:39to a County Court, to present the case to a district judge,
0:31:39 > 0:31:41to find that this claim was fundamentally dishonest.
0:31:41 > 0:31:46Gary Burnett wasn't going to be able to simply walk away from this.
0:31:46 > 0:31:50On the day of the court hearing, perhaps knowing he was beaten,
0:31:50 > 0:31:53Burnett decided not to attend.
0:31:53 > 0:31:59The fact that the claimant didn't turn up to the initial civil hearing
0:31:59 > 0:32:03probably did hinder his defence to it,
0:32:03 > 0:32:07but the judge was satisfied that, based on the evidence presented,
0:32:07 > 0:32:10that there was more than enough to find that the claim
0:32:10 > 0:32:13was fundamentally dishonest. The outcome of the civil case
0:32:13 > 0:32:17was that the claim was abandoned completely by Mr Burnett
0:32:17 > 0:32:20and he was ordered to repay Aviva's legal costs of £11,000.
0:32:22 > 0:32:24Burnett didn't receive a penny of the £2,000 he had claimed
0:32:24 > 0:32:27from Aviva in compensation.
0:32:27 > 0:32:30And he now faces an £11,000 bill.
0:32:30 > 0:32:33It was 1-0 to Aviva,
0:32:33 > 0:32:36but this match wasn't over.
0:32:36 > 0:32:40The civil judge, in a bold move, decided to refer this case up to
0:32:40 > 0:32:42the Attorney General's Office.
0:32:42 > 0:32:47The Attorney General is the main legal adviser to the government.
0:32:47 > 0:32:49They, along with the Solicitor General,
0:32:49 > 0:32:52work to ensure the justice system is properly served
0:32:52 > 0:32:54and the public interest looked after.
0:32:56 > 0:33:01Within the last 12 months, we have taken in the region
0:33:01 > 0:33:05of 400 cases to trial and this is the first one of those 400 cases
0:33:05 > 0:33:08that was referred to the Attorney General.
0:33:08 > 0:33:12This was a fact that it was such a brazen lie by the claimant to say,
0:33:12 > 0:33:14not only to the medical expert, but also to Aviva,
0:33:14 > 0:33:16also to the court, as well, that he was unable to play football.
0:33:16 > 0:33:20It was a very, very serious lie. The court thought it was serious
0:33:20 > 0:33:23enough to refer that on to the Attorney General,
0:33:23 > 0:33:26- to consider prosecution. - The Attorney General's Office
0:33:26 > 0:33:29decided that Gary Burnett was guilty of contempt of court -
0:33:29 > 0:33:31a criminal offence.
0:33:31 > 0:33:35Contempt of court is where someone disrespects court proceedings
0:33:35 > 0:33:37and makes a trial unfair by their actions.
0:33:37 > 0:33:40Gary Burnett had told one too many lies.
0:33:40 > 0:33:44Our Solicitor General, Robert Buckland QC, explains.
0:33:44 > 0:33:48Well, it was very serious. The court that dealt with
0:33:48 > 0:33:52the contempt case made him subject to a four-month sentence
0:33:52 > 0:33:54of imprisonment, suspended for a year.
0:33:54 > 0:33:59Because the court viewed it as essential to send a clear message
0:33:59 > 0:34:06to the public at large that this sort of deliberate, systematic
0:34:06 > 0:34:09dishonesty, that was fundamental to the case that he brought
0:34:09 > 0:34:12in the County Court, will not be tolerated,
0:34:12 > 0:34:16because it undermines the integrity of the civil justice system.
0:34:16 > 0:34:21Burnett's blatant attempt to defraud Aviva had left him with a hefty bill
0:34:21 > 0:34:24to pay and now a permanent criminal record.
0:34:24 > 0:34:28This footballer's case had been used to illustrate how committed
0:34:28 > 0:34:31the justice system is to tackling insurance fraud.
0:34:31 > 0:34:36The system of insurance and the costs of insurance premiums
0:34:36 > 0:34:40and the rising cost of premiums, if people make false claims,
0:34:40 > 0:34:43is clearly a matter of public interest.
0:34:43 > 0:34:45And, as a guardian of the public interest,
0:34:45 > 0:34:48I think it is incumbent upon this office to get involved,
0:34:48 > 0:34:50where we see such serious cases.
0:34:53 > 0:34:56For Aviva's solicitors, Horwich Farrelly, this was a landmark case,
0:34:56 > 0:34:59which they believe will act as a strong deterrent.
0:35:01 > 0:35:03We are very satisfied with the outcome of the case.
0:35:03 > 0:35:06Mr Burnett presented what was clearly a dishonest claim
0:35:06 > 0:35:08from the outset. This is the first of its kind,
0:35:08 > 0:35:11where the Attorney General has not only taken on the case,
0:35:11 > 0:35:14but successfully prosecuted the claimant for contempt of court
0:35:14 > 0:35:15and for insurance fraud.
0:35:15 > 0:35:19It shows that the insurance industry now has the backing
0:35:19 > 0:35:22of the government and has the backing of people like
0:35:22 > 0:35:25the Attorney General in prosecuting dishonest claimants,
0:35:25 > 0:35:28regardless of the value of the claim.
0:35:33 > 0:35:38It is extraordinary the lengths serious fraudsters will go
0:35:38 > 0:35:42for financial gain. Most draw the line at causing actual physical harm
0:35:42 > 0:35:46to others, in order to make a buck. The key word there is "most"
0:35:46 > 0:35:49because there are some who will, literally, stop at nothing
0:35:49 > 0:35:51to line their own pockets.
0:35:54 > 0:35:58North Port is an affluent residential district in Florida.
0:35:58 > 0:36:02It was home to Janine Jones and her husband, Matthew Riley Smith.
0:36:02 > 0:36:06Janine, who was once a corrections officer at the local county jail,
0:36:06 > 0:36:08was now up to no good herself.
0:36:10 > 0:36:14She and Matthew had a profitable, but totally illegal, scam going on.
0:36:14 > 0:36:18They were renting out abandoned and foreclosed homes
0:36:18 > 0:36:21to unsuspecting tenants across North Port.
0:36:21 > 0:36:25The scheme was making them rich. Rich beyond their wildest dreams.
0:36:27 > 0:36:31But there was a problem. Someone had got wind of what they were doing -
0:36:31 > 0:36:34a handyman who worked for them, called John Chamberlain.
0:36:34 > 0:36:37And he was threatening to expose them.
0:36:38 > 0:36:41Janine needed a way to make sure John kept quiet
0:36:41 > 0:36:44and decided that the only way to shut him up for good
0:36:44 > 0:36:46was to hire a hit man.
0:36:46 > 0:36:48But Janine didn't stop there.
0:36:48 > 0:36:52She also decided she'd had enough of sharing her ill-gotten gains
0:36:52 > 0:36:55with husband Matthew and she decided she would
0:36:55 > 0:36:57have him executed, as well.
0:36:59 > 0:37:03Janine took out a life insurance policy worth 1 million
0:37:03 > 0:37:06on Matthew and prepared to meet with the hit man.
0:37:08 > 0:37:11The meeting was facilitated by a middle woman,
0:37:11 > 0:37:14who'd organised it to take place in a car.
0:37:17 > 0:37:20Incredibly, what you're seeing is the actual footage
0:37:20 > 0:37:24- from that first meeting. - Hello.- How you doing?- How are you?
0:37:25 > 0:37:29To start off, Janine shows the hit man a photo of her first
0:37:29 > 0:37:31intended victim, John.
0:37:53 > 0:37:57She appears to have no remorse about the fact she's about to have
0:37:57 > 0:37:58someone's father killed.
0:38:01 > 0:38:03The conversation turns to her husband, Matthew.
0:38:23 > 0:38:27Janine is keen to stress that Matthew might be a trickier target.
0:38:43 > 0:38:46On a dark version of a neighbourhood tour,
0:38:46 > 0:38:49Janine points out where her first target, John, lives.
0:39:10 > 0:39:12The talk soon gets serious.
0:39:12 > 0:39:15And, extraordinarily, she tells the hit man how she would like
0:39:15 > 0:39:17the first murder to happen.
0:39:17 > 0:39:20Just a warning, this does make for disturbing viewing.
0:39:57 > 0:40:00The hit man next asks her how she wants her husband's murder
0:40:00 > 0:40:02to happen.
0:40:28 > 0:40:31There seemed no end to Janine's maliciousness.
0:40:31 > 0:40:35She had now suggested ways of killing two men -
0:40:35 > 0:40:38one her own husband - without showing the slightest emotion.
0:40:40 > 0:40:42In John's case, her motive was to stop him talking to the police
0:40:42 > 0:40:44about her illegal property scam.
0:40:44 > 0:40:46And, in her husband's case,
0:40:46 > 0:40:51it was to get a 1 million pay-out from his life insurance.
0:40:51 > 0:40:53This was an evil, greedy woman.
0:40:56 > 0:40:58However, unbeknownst to Janine,
0:40:58 > 0:41:00the middle woman who had organised the meeting
0:41:00 > 0:41:03had, in reality, sold her out to the police.
0:41:04 > 0:41:08So, Janine had just revealed her wicked plan not to a hit man,
0:41:08 > 0:41:09but to an undercover cop.
0:41:13 > 0:41:16The middle woman, who was helping the police, arranged to meet her
0:41:16 > 0:41:18just once more, under the guise of wanting to finalise
0:41:18 > 0:41:21all the details of the first murder.
0:41:22 > 0:41:25This time, they met in a local diner.
0:41:25 > 0:41:27As Janine calmly ate her meal,
0:41:27 > 0:41:30no-one could have imagined what was being discussed.
0:41:40 > 0:41:43Fortunately, for her employee John and her husband Matthew,
0:41:43 > 0:41:46this was as far as Janine's hideous plan got.
0:41:46 > 0:41:51Waiting outside the diner were several police officers,
0:41:51 > 0:41:53who immediately arrested her.
0:41:55 > 0:41:57In June 2014,
0:41:57 > 0:41:59Janine Jones was sentenced to life in prison,
0:41:59 > 0:42:02for trying to get two men killed.
0:42:04 > 0:42:06But there was a menacing twist.
0:42:06 > 0:42:10A few years earlier, Janine's first husband Max
0:42:10 > 0:42:12had died under mysterious circumstances.
0:42:12 > 0:42:16And it had to be more than a coincidence that, when he died,
0:42:16 > 0:42:20Janine received a life insurance pay-out for, you guessed it,
0:42:20 > 0:42:221 million.
0:42:23 > 0:42:27Max's family and the police believe that Janine had a hand in his death.
0:42:27 > 0:42:30But it's hard to prove, as Janine had Max's body
0:42:30 > 0:42:33quickly cremated after he died.
0:42:39 > 0:42:41Whether it's exaggerating real injuries,
0:42:41 > 0:42:44totally making up a story for a dodgy claim,
0:42:44 > 0:42:48or masterminding insurance fraud on an industrial scale,
0:42:48 > 0:42:51insurers are coming down hard on the people who think they can make
0:42:51 > 0:42:54a quick buck with their scams and cons.
0:42:54 > 0:42:57But the fraudsters need to think again, as more of them than
0:42:57 > 0:43:00ever before have been caught in the act,
0:43:00 > 0:43:01and claimed and shamed.