0:00:02 > 0:00:03TYRES SCREECH
0:00:06 > 0:00:09Insurance fraud in the UK has hit epidemic levels.
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 > 0:00:21Deliberate crashes, bogus personal
0:00:21 > 0:00:24injuries, even phantom pets.
0:00:25 > 0:00:27The fraudsters are risking more and
0:00:27 > 0:00:29more to make a quick killing and,
0:00:29 > 0:00:31every year, it's adding around £50
0:00:31 > 0:00:33to 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 > 0:00:43That's the subject out the vehicle.
0:00:43 > 0:00:46..sophisticated data analysis techniques...
0:00:46 > 0:00:47TYRES SCREECH
0:00:47 > 0:00:49Police!
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 the criminals red-handed.
0:00:55 > 0:00:58Just don't lie to us.
0:00:58 > 0:01:01All those conmen, scammers and cheats on the fiddle
0:01:01 > 0:01:04are now caught in the act, and claimed and shamed.
0:01:11 > 0:01:14A serial fraudster is brought down to Earth with a bump.
0:01:14 > 0:01:18Mr Sudipo probably thought that rejecting this claim for the second
0:01:18 > 0:01:21time is the worst thing that could happen to him.
0:01:21 > 0:01:24However, there are severe penalties for fraud.
0:01:24 > 0:01:27Secret filming proves to be the undoing of a man claiming to be so
0:01:27 > 0:01:30badly injured he's unable to work.
0:01:30 > 0:01:34There was absolutely no room to dispute that he was
0:01:34 > 0:01:38working and was keeping that work hidden.
0:01:38 > 0:01:39And, in the USA,
0:01:39 > 0:01:42a convicted fraudster goes to extraordinary lengths to avoid
0:01:42 > 0:01:44a ten-year prison sentence.
0:01:59 > 0:02:00When we head off to work,
0:02:00 > 0:02:04it's the responsibility of our employer to provide a safe working
0:02:04 > 0:02:08environment. However, it's a fact of life that accidents will happen and,
0:02:08 > 0:02:10in the event that disaster strikes,
0:02:10 > 0:02:14insurance is there to protect both our employers and us.
0:02:14 > 0:02:17But, of course, there are some people out there who see that as an
0:02:17 > 0:02:19opportunity to cash in.
0:02:26 > 0:02:30In 2015, there were over 600,000 workplace accidents...
0:02:33 > 0:02:36..which resulted in over 30 million lost working days.
0:02:41 > 0:02:45Allianz recently dealt with a case that first started over 15 years
0:02:45 > 0:02:49ago, and highlights just how audacious some fraudsters are in
0:02:49 > 0:02:52their pursuit of a pay-out, even if
0:02:52 > 0:02:55they've already received compensation.
0:02:55 > 0:02:57In 2001,
0:02:57 > 0:03:01we received a genuine personal injury claim from a factory worker
0:03:01 > 0:03:04called Mr Sudipo.
0:03:04 > 0:03:06And, as injuries go,
0:03:06 > 0:03:10this was far more than a sprained ankle or a few cuts and bruises.
0:03:10 > 0:03:12He fell through a defective floor...
0:03:12 > 0:03:13Ooh!
0:03:14 > 0:03:17..which caused him to have a fractured vertebrae,
0:03:17 > 0:03:19leading to a spinal cord injury.
0:03:22 > 0:03:25Whilst on the face of it that appeared quite serious in nature,
0:03:25 > 0:03:29the evidence indicated that this would be a situation where his
0:03:29 > 0:03:31injuries would heal over time.
0:03:33 > 0:03:37Thankfully, Mr Sudipo went on to make a full recovery.
0:03:37 > 0:03:40But as the accident had occurred whilst he was at work,
0:03:40 > 0:03:43he was entitled to compensation from his employer.
0:03:44 > 0:03:46Based upon the evidence presented,
0:03:46 > 0:03:51the claim was settled for the sum of £5,250.
0:03:51 > 0:03:53So, that was that, then.
0:03:53 > 0:03:54Well, not quite.
0:03:56 > 0:03:59Usually, this would be the end of the matter.
0:03:59 > 0:04:02To our surprise, nine years after this event...
0:04:03 > 0:04:06..the same claimant pursued exactly
0:04:06 > 0:04:08the same claim with the same
0:04:08 > 0:04:12employer, under the same circumstances...
0:04:12 > 0:04:14as we dealt with in 2001.
0:04:18 > 0:04:20TABLET EFFERVESCES
0:04:20 > 0:04:24This arose some suspicions internally
0:04:24 > 0:04:26and started our investigation process.
0:04:28 > 0:04:31Our claims handler immediately contacted the company who he
0:04:31 > 0:04:33allegedly worked for at the time of the accident.
0:04:34 > 0:04:39These checks soon validated that he was not employed, as alleged,
0:04:39 > 0:04:40at the time of this accident.
0:04:40 > 0:04:45In fact, he had not returned to work after the original accident in 2001.
0:04:46 > 0:04:49So, let's get this straight.
0:04:49 > 0:04:52Mr Sudipo had never returned to work at the company where he made
0:04:52 > 0:04:55his first claim, so it was impossible for him to have had
0:04:55 > 0:04:59another accident there. But, here he was, nine years later,
0:04:59 > 0:05:03attempting to cash in with an identical claim.
0:05:04 > 0:05:07No prizes for guessing what happened next.
0:05:07 > 0:05:09Armed with this information,
0:05:09 > 0:05:12it was an easy decision for Allianz to reject the claim.
0:05:12 > 0:05:13For whatever reason,
0:05:13 > 0:05:18Sudipo thought he could get the same claim through the system a second time.
0:05:18 > 0:05:22But having discovered it wasn't as easy to get one over insurers as he
0:05:22 > 0:05:25thought, you'd expect he'd call it a day.
0:05:25 > 0:05:27Well, think again.
0:05:28 > 0:05:30Unbelievably, to our surprise, this wasn't the end of the case.
0:05:32 > 0:05:37The individual concerned then intimated a third claim related to
0:05:37 > 0:05:42another workplace accident that allegedly took place in July 2012.
0:05:42 > 0:05:47Again, this accident provided the same set of circumstances as
0:05:47 > 0:05:50described in 2001 and 2008,
0:05:50 > 0:05:52and alleged the same injuries.
0:05:52 > 0:05:53MAN GASPS
0:05:55 > 0:05:59Now, I'm no gambler, but even with my limited knowledge,
0:05:59 > 0:06:03I'd say the odds of someone having exactly the same accident with the
0:06:03 > 0:06:07same injuries three times in 12 years,
0:06:07 > 0:06:10at a place he hasn't even worked at for 12 years,
0:06:10 > 0:06:14are around absolute zero.
0:06:14 > 0:06:17And, unsurprisingly, Allianz thought exactly the same.
0:06:20 > 0:06:25Our checks carried out on the earlier claim clearly enabled us to
0:06:25 > 0:06:28reject this claim immediately, without any further investigation.
0:06:32 > 0:06:35If Sudipo thought he could chance his arm time after time
0:06:35 > 0:06:40in the hope of a pay-out with no consequence, then he was sorely mistaken.
0:06:41 > 0:06:44It was obvious at this point that the claimant didn't feel that there
0:06:44 > 0:06:49was any consequences upon intimating the same claim three times.
0:06:49 > 0:06:53Mr Sudipo probably thought that rejecting this claim for the second
0:06:53 > 0:06:56time is the worst thing that could happen to him.
0:06:56 > 0:06:59However, there are severe penalties for fraud,
0:06:59 > 0:07:04and we have options to pursue various action against the individual concerned.
0:07:04 > 0:07:06This action can lead to
0:07:06 > 0:07:09prison sentence, fine,
0:07:09 > 0:07:12community service or a criminal record.
0:07:12 > 0:07:15And, armed with all the evidence available in this case,
0:07:15 > 0:07:20the matter was referred by our claims handlers to IFED -
0:07:20 > 0:07:23the Insurance Fraud Enforcement Department
0:07:23 > 0:07:25for them to consider whether there
0:07:25 > 0:07:27was options for criminal prosecution.
0:07:28 > 0:07:33IFED were happy to take the case on, and brought Sudipo in for questioning.
0:07:34 > 0:07:38IFED proceeded to take a statement from the claimant under caution,
0:07:38 > 0:07:41as well as a statement from our claims handlers.
0:07:41 > 0:07:45With this evidence, they made the decision to pursue the matter to court.
0:07:45 > 0:07:46Ooh!
0:07:46 > 0:07:49What had begun as a genuine and very serious accident worthy of
0:07:49 > 0:07:54compensation had descended into an opportunist attempt to cash in again
0:07:54 > 0:07:57and again, fuelled by greed.
0:07:57 > 0:08:00But for Sudipo, it was the end of the line.
0:08:00 > 0:08:03The claimant appeared at Magistrates' Court
0:08:03 > 0:08:05where he entered a guilty plea.
0:08:05 > 0:08:08The court handed down a 12-month community order,
0:08:08 > 0:08:1180 hours of community service,
0:08:11 > 0:08:15and the claimant was ordered to pay court fees and surcharges.
0:08:16 > 0:08:20As you'd expect, fraud managers like Mark see more than their fair share
0:08:20 > 0:08:24of chancers, but the sheer brazenness of Sudipo to claim for
0:08:24 > 0:08:27the same accident not twice,
0:08:27 > 0:08:30but three times, was a rare occurrence indeed.
0:08:30 > 0:08:32The judgment handed down
0:08:32 > 0:08:37demonstrates there are consequences attached to bringing dishonest claims.
0:08:37 > 0:08:41The individual concerned has got a criminal record,
0:08:41 > 0:08:45and now has to deal with the consequence of that record for the rest of his life.
0:08:53 > 0:08:56..a claimant is given a rude awakening when she attempts to
0:08:56 > 0:08:59upgrade herself to a better night's sleep.
0:08:59 > 0:09:01They told us that this mattress was
0:09:01 > 0:09:04not one of their high-end mattresses.
0:09:04 > 0:09:08And a football fan is caught offside as he struggles to get his
0:09:08 > 0:09:09story straight.
0:09:22 > 0:09:26Home insurance can be a real life-saver and provides peace of
0:09:26 > 0:09:29mind that should anything happen to any of our valuables, no matter how
0:09:29 > 0:09:35big or small, they're protected. But many fraudsters are shameless,
0:09:35 > 0:09:39concocting evermore creative tales in an effort to make a quick buck
0:09:39 > 0:09:41at the expense of insurance companies.
0:09:49 > 0:09:52You never know when disaster might strike in the home...
0:09:54 > 0:09:55..from a blazing house fire...
0:09:57 > 0:09:58..to an unwanted visitor.
0:10:00 > 0:10:02A home insurance policy is there to
0:10:02 > 0:10:03cover the cost of replacing our
0:10:03 > 0:10:05possessions, like for like.
0:10:08 > 0:10:12But as RSA's head of counter-fraud John Beadle knows,
0:10:12 > 0:10:14not all claims are straightforward.
0:10:14 > 0:10:17He was asked to look into a case for a claimant who thought they could
0:10:17 > 0:10:19catch the insurer napping.
0:10:21 > 0:10:24This case was a household policy
0:10:24 > 0:10:29which had an accidental damage clause in policy.
0:10:29 > 0:10:35The lady said she was cleaning her windows with bleach when she
0:10:35 > 0:10:39accidentally knocked the bowl on to her bed,
0:10:39 > 0:10:42and it caused damage to her
0:10:42 > 0:10:45mattress, the bedclothes and the bed frame.
0:10:45 > 0:10:48Spills around the house are nothing new,
0:10:48 > 0:10:51although what set this one apart from your average home insurance
0:10:51 > 0:10:55claim was the quality of the mattress in question.
0:10:55 > 0:10:58Well, she obviously valued a good night's sleep because she told us
0:10:58 > 0:11:02that the mattress was a very expensive Vispring mattress,
0:11:02 > 0:11:05and the total claim was valued at £4,000.
0:11:06 > 0:11:10At £4,000, this wasn't your average mattress.
0:11:11 > 0:11:14It seemed like a perfectly legitimate claim at the time,
0:11:14 > 0:11:19and we began to make arrangements to settle the claim.
0:11:19 > 0:11:20So, in no time at all,
0:11:20 > 0:11:24the woman would be enjoying a good night's sleep on a brand-new replacement mattress.
0:11:26 > 0:11:30Generally speaking, we try and pay claims as quickly as possible.
0:11:30 > 0:11:37We're quite proud of our ability to quickly settle claims and reinstate
0:11:37 > 0:11:42people into the position that they were before the accident or loss occurred.
0:11:42 > 0:11:48But we are quite sophisticated now in the way that we screen claims.
0:11:48 > 0:11:53And, of course, we do inspect damage in the normal course of settlement of the claim.
0:11:54 > 0:11:55Unfortunately for the woman,
0:11:55 > 0:11:57it was at this stage that her claim
0:11:57 > 0:12:00for a new mattress turned into a bit of a nightmare.
0:12:01 > 0:12:03On inspecting the mattress,
0:12:03 > 0:12:07we soon established that it wasn't as straightforward as it seemed.
0:12:08 > 0:12:10When our people visited the premises,
0:12:10 > 0:12:16they found that the label on the mattress had been torn out,
0:12:16 > 0:12:19and on what remained had been written, hand-written,
0:12:19 > 0:12:22"A Vispring mattress."
0:12:22 > 0:12:24We didn't believe that that was the case,
0:12:24 > 0:12:27so we began to challenge the claim
0:12:27 > 0:12:31in respect of the damaged goods.
0:12:31 > 0:12:35Unless it was part of the company's marketing strategy to make every mattress unique,
0:12:35 > 0:12:40you wouldn't expect a £4,000 luxury product to feature a label with the
0:12:40 > 0:12:43name hand-written in pen.
0:12:44 > 0:12:48Unsurprisingly, the insurance company dug a little deeper.
0:12:48 > 0:12:51We went and saw the bed manufacturers,
0:12:51 > 0:12:57and they told us that this mattress was not one of their high-end mattresses.
0:12:57 > 0:12:59Given the state of the mattress and the label,
0:12:59 > 0:13:02this news wasn't exactly the shock of the century.
0:13:03 > 0:13:09It was obvious that attempts had been made to portray what was a
0:13:09 > 0:13:13standard type of mattress, probably valued at about £800,
0:13:13 > 0:13:17as a high-end Vispring mattress.
0:13:17 > 0:13:20If the woman thought she could swindle her way to a top-of-the-line
0:13:20 > 0:13:24mattress five times the value of her original one,
0:13:24 > 0:13:26then she really was dreaming.
0:13:28 > 0:13:29It was pretty crude.
0:13:29 > 0:13:33Clearly, this lady was trying to claim for goods which she wasn't
0:13:33 > 0:13:38entitled to, rather than just be reinstated with the goods that had been damaged.
0:13:38 > 0:13:43The woman's attempt to better her bedding had backfired badly, and it
0:13:43 > 0:13:46was time to put this claim to bed.
0:13:46 > 0:13:49We voided the policy for fraud
0:13:49 > 0:13:52and the claimant got no compensation
0:13:52 > 0:13:55for their damaged goods.
0:13:55 > 0:13:57And I want to make the point that
0:13:57 > 0:13:59people who think that it's OK to
0:13:59 > 0:14:02exaggerate a claim in this way
0:14:02 > 0:14:06should realise that, actually, it's fraud
0:14:06 > 0:14:08and you will be found out,
0:14:08 > 0:14:11because insurance companies are not a soft touch.
0:14:11 > 0:14:15And the consequences are either that we will prosecute you or,
0:14:15 > 0:14:16as in this case,
0:14:16 > 0:14:20your name will be entered on the Insurance Fraud Register, which will
0:14:20 > 0:14:23cause you problems in obtaining insurance cover in the future.
0:14:31 > 0:14:33When it comes to the fight against insurance fraud,
0:14:33 > 0:14:35the industry is stepping up its game,
0:14:35 > 0:14:40with insurers going to increasing lengths to catch out dishonest individuals.
0:14:40 > 0:14:45Many fraudsters make the mistake of thinking it won't be them that gets caught.
0:14:45 > 0:14:46But as this next case demonstrates,
0:14:46 > 0:14:49that couldn't be further from the truth.
0:14:55 > 0:14:59I-cog Claims Management is a company that specialises in identifying
0:14:59 > 0:15:03fraudulent insurance claims through various techniques,
0:15:03 > 0:15:06including secret filming...
0:15:06 > 0:15:07..and desktop investigation.
0:15:08 > 0:15:11They recently took on a case where an insurer had doubts about whether
0:15:11 > 0:15:15one of their policy holder's claims was genuine.
0:15:16 > 0:15:21The claim that was presented to insurers was for an individual who
0:15:21 > 0:15:25had said that he had fractured his right hand and wrist.
0:15:25 > 0:15:29And clearly, as a result of that, he wasn't able to work in any capacity.
0:15:31 > 0:15:36For many of us, an injury such as this would be disastrous for our livelihood.
0:15:36 > 0:15:38However, the claimant in this case had made
0:15:38 > 0:15:40provisions for the unexpected.
0:15:41 > 0:15:44Fortunately for him, he had an income
0:15:44 > 0:15:46protection policy and, as a result,
0:15:46 > 0:15:49duly submitted a claim that he was unable to work.
0:15:49 > 0:15:50PEN SCRATCHES
0:15:50 > 0:15:52By the time we had actually received the claim,
0:15:52 > 0:15:55he'd already received £20,000 in
0:15:55 > 0:15:57payment, with a maturing value
0:15:57 > 0:16:00against the entire policy reaching 28,000.
0:16:00 > 0:16:02Thanks to this income protection policy,
0:16:02 > 0:16:04the claimant had the luxury of being
0:16:04 > 0:16:06able to make a full recovery,
0:16:06 > 0:16:08safe in the knowledge that he would
0:16:08 > 0:16:10still have money coming in until he
0:16:10 > 0:16:12was fit enough to return to work.
0:16:12 > 0:16:15A very nice position to be in, indeed.
0:16:15 > 0:16:17But there was a problem.
0:16:18 > 0:16:21The claim had been referred to us because the insurer just happened to
0:16:21 > 0:16:25notice that the mobile phone number for the claimant was actually the
0:16:25 > 0:16:27same of a self-employed renovation
0:16:27 > 0:16:30business that had just set up in the area.
0:16:30 > 0:16:34The rules on income protection policies are clear.
0:16:34 > 0:16:36They're there to protect the policy-holder
0:16:36 > 0:16:38in the event they cannot work.
0:16:38 > 0:16:41So, if the claimant was working and running a business,
0:16:41 > 0:16:45then Tara and her team could potentially be dealing with a fraudulent claim.
0:16:47 > 0:16:51I actually decided that an enquiry be made with the renovation
0:16:51 > 0:16:54company to see if we could obtain a quote.
0:17:27 > 0:17:28During that inquiry,
0:17:28 > 0:17:32not only was the claimant far too busy with renovation work to provide
0:17:32 > 0:17:36us with a quote, he was actually going on holiday
0:17:36 > 0:17:37and advised that he was actively
0:17:37 > 0:17:40returning to a busy schedule upon return.
0:17:41 > 0:17:45The phone conversation suggested that business was booming.
0:17:45 > 0:17:51But it still didn't prove whether the claimant was definitely the man on the other end of the phone.
0:17:51 > 0:17:53To be sure of that, Tara needed to take the
0:17:53 > 0:17:55investigation a step further.
0:17:55 > 0:17:58So, at that stage, we had an intelligence package,
0:17:58 > 0:18:01and confirmation, with an enquiry.
0:18:01 > 0:18:05So, the natural stage for me was to authorise for surveillance to then commence.
0:18:07 > 0:18:08Secret filming, to you and I.
0:18:08 > 0:18:12If successful, the undercover operation would provide the
0:18:12 > 0:18:14insurance company with the bulletproof evidence
0:18:14 > 0:18:18they needed to prove that the claim was fraudulent.
0:18:21 > 0:18:24For several days, the surveillance team waited...
0:18:30 > 0:18:31..and waited...
0:18:35 > 0:18:37..and waited.
0:18:43 > 0:18:45But nothing happened.
0:18:54 > 0:18:58Perhaps the claimant wasn't actually working, after all.
0:18:59 > 0:19:02On the first few days of the operation,
0:19:02 > 0:19:05there wasn't really any activity to report.
0:19:09 > 0:19:12Now, one may think, "Oh, well, we must have been wrong."
0:19:12 > 0:19:15But, because the intelligence package was so strong,
0:19:15 > 0:19:18we were confident that our findings would pay off.
0:19:23 > 0:19:27Sure enough, the very next day, the claimant emerged.
0:19:27 > 0:19:30The big question, though, is where was he going?
0:19:30 > 0:19:34He was followed to several trade merchants.
0:19:34 > 0:19:38And there was nothing to suggest his alleged injuries were preventing him
0:19:38 > 0:19:40from using his right hand.
0:19:41 > 0:19:45Here, he's actually lifted a bag of cement from the store,
0:19:45 > 0:19:48carrying it in the broken and fractured right hand and wrist,
0:19:48 > 0:19:50without any issue at all.
0:19:50 > 0:19:53And now he's actually loading it into the vehicle.
0:19:54 > 0:19:57If the man had ever suffered the injuries he was claiming for,
0:19:57 > 0:20:01it definitely didn't look like they were causing him any problems now,
0:20:01 > 0:20:04and, crucially, they definitely weren't preventing him from working.
0:20:06 > 0:20:10Here, the claimant can be clearly seen carrying out what I would call
0:20:10 > 0:20:16manual work, again using the right hand without any issue whatsoever,
0:20:16 > 0:20:20and carrying out which, to me, was clearly work for payment.
0:20:20 > 0:20:23I think what's important to note with this one is, during
0:20:23 > 0:20:27the surveillance, he was still receiving payments for being unable to work,
0:20:27 > 0:20:31and essentially being temporarily disabled in the hand.
0:20:31 > 0:20:33Well, that wasn't what we secured on film.
0:20:35 > 0:20:38The surveillance footage was the indisputable proof that Tara and her
0:20:38 > 0:20:41team needed to confirm the insurer's suspicions.
0:20:41 > 0:20:44It's quite interesting. There's a saying, "The camera never lies."
0:20:44 > 0:20:48That's one of the beauties of surveillance as a tactic within the
0:20:48 > 0:20:53claims validation process, because what you see on camera here,
0:20:53 > 0:20:58there was absolutely no room to dispute that he was working and was
0:20:58 > 0:21:00keeping that work hidden from his insurer.
0:21:00 > 0:21:02But ultimately we found him out.
0:21:04 > 0:21:07The findings of the investigation and a copy of the footage were
0:21:07 > 0:21:09handed over to the insurer.
0:21:09 > 0:21:13The claim was struck out and the claimant was blacklisted.
0:21:13 > 0:21:17What was important is that we had identified a fraudulent claim that
0:21:17 > 0:21:21had been admitted. Justice had taken its course,
0:21:21 > 0:21:25and this person will never, ever get insurance like this again.
0:21:26 > 0:21:29Dishonest claims like this cost all of us,
0:21:29 > 0:21:34but the industry is going to greater lengths to identify those who commit them.
0:21:34 > 0:21:39I think it's fair to say that most insurers do whatever it takes to
0:21:39 > 0:21:43protect their genuine customer base,
0:21:43 > 0:21:47and that we all have a duty to identify fraud,
0:21:47 > 0:21:50secure the evidence and take the appropriate action.
0:21:56 > 0:21:59Now, we've heard about the shocking lengths insurance cheats in the UK
0:21:59 > 0:22:04will go to in order to cash in on an insurance policy.
0:22:04 > 0:22:07But many of these crimes pale in comparison to how far some
0:22:07 > 0:22:11fraudsters in the USA go to get their hands on money that they
0:22:11 > 0:22:14simply aren't entitled to.
0:22:24 > 0:22:30Property, or "real estate" as it's called on the other side of the pond, is big business.
0:22:30 > 0:22:34One man who knew that all too well was Shannon Egeland.
0:22:34 > 0:22:37He was the vice president of Desert Sun Development,
0:22:37 > 0:22:40a real estate business that constructed commercial and
0:22:40 > 0:22:42residential buildings in the state of Oregon.
0:22:45 > 0:22:46However, Desert Sun Development
0:22:46 > 0:22:49wasn't your average real estate company.
0:22:49 > 0:22:53In fact, it was a front for a huge mortgage fraud operation
0:22:53 > 0:22:54worth over 20 million.
0:22:57 > 0:22:59Most of the funds the company secured for building properties
0:22:59 > 0:23:03went straight into the pockets of Egeland and his accomplices,
0:23:03 > 0:23:07with very little construction ever actually taking place.
0:23:10 > 0:23:13As one of the principal orchestrators of the scam,
0:23:13 > 0:23:14Egeland fraudulently obtained
0:23:14 > 0:23:17millions of dollars, which he used
0:23:17 > 0:23:20to fund a lavish lifestyle that included
0:23:20 > 0:23:23multi-million dollar properties, luxury cars and boats.
0:23:23 > 0:23:25Eventually, the scam was busted by
0:23:25 > 0:23:28the FBI, and in January 2014,
0:23:28 > 0:23:30Egeland was sentenced to ten years
0:23:30 > 0:23:33behind bars for his part in the fraud.
0:23:36 > 0:23:38After pleading with the court,
0:23:38 > 0:23:42citing his wife's chronic health problems and the dire situation she
0:23:42 > 0:23:43and their children would face,
0:23:43 > 0:23:46the judge gave him six months to care for his ill wife
0:23:46 > 0:23:51and ordered him to report to prison on the 1st of August 2014.
0:23:53 > 0:23:57Now, having been given the luxury of another six months' grace as a free
0:23:57 > 0:24:01man, you'd think Egeland would use this time wisely by looking after
0:24:01 > 0:24:04his wife and spending quality time with his family,
0:24:04 > 0:24:08but instead he used it to plot a way to delay his impending jail
0:24:08 > 0:24:10sentence even further.
0:24:13 > 0:24:16The day before Egeland was due to begin his ten-year jail term,
0:24:16 > 0:24:20an incredible series of events unfolded.
0:24:20 > 0:24:22He was driving near Caldwell, Idaho,
0:24:22 > 0:24:25when he stopped to help a pregnant motorist.
0:24:25 > 0:24:28But as he got out of the car, he was attacked.
0:24:34 > 0:24:35GUNSHOT
0:25:13 > 0:25:17By trying to be a Good Samaritan, Egeland had been viciously attacked,
0:25:17 > 0:25:20and was now at risk of bleeding to death.
0:25:55 > 0:25:57HE YELLS
0:25:57 > 0:26:01Thankfully, the emergency services arrived in time
0:26:01 > 0:26:03and Egeland was rushed to hospital.
0:26:05 > 0:26:07As he needed extensive medical treatment,
0:26:07 > 0:26:11Egeland's lawyer filed a request for his prison sentence to be
0:26:11 > 0:26:13delayed by two and a half months.
0:26:13 > 0:26:16However, when medical complications meant that Egeland's foot had to be
0:26:16 > 0:26:21amputated, the sentence was postponed even further.
0:26:23 > 0:26:26But the shooting just didn't add up.
0:26:26 > 0:26:30The police couldn't find any motive for the attack, and nothing had been taken.
0:26:30 > 0:26:36Egeland's phone, wallet and BMW were all left untouched at the scene.
0:26:36 > 0:26:39As the police investigation continued,
0:26:39 > 0:26:42the circumstances became increasingly suspicious.
0:26:42 > 0:26:45It transpired that just a week before the shooting,
0:26:45 > 0:26:49Egeland had fraudulently taken out a disability insurance policy.
0:26:49 > 0:26:53In order to secure the policy, he had lied on the application form,
0:26:53 > 0:26:57saying that he hadn't been arrested in the past ten years -
0:26:57 > 0:27:01whereas he had, in fact, been arrested numerous times.
0:27:02 > 0:27:04As part of the investigation,
0:27:04 > 0:27:07Egeland's wife and teenage son were interviewed by the police,
0:27:07 > 0:27:09and it was then that the extraordinary truth
0:27:09 > 0:27:12finally came to light.
0:27:12 > 0:27:13Under questioning,
0:27:13 > 0:27:16Egeland's son broke down and confessed that his father had staged
0:27:16 > 0:27:21the entire roadside encounter in an attempt to delay his prison sentence
0:27:21 > 0:27:23and to cash in on his fraudulently obtained
0:27:23 > 0:27:26disability insurance policy.
0:27:26 > 0:27:30But most shocking of all was the identity of the attacker.
0:27:30 > 0:27:33Egeland had maintained throughout it was a Mexican male,
0:27:33 > 0:27:37but in actual fact, it was Egeland's own son.
0:27:37 > 0:27:38Under his father's orders,
0:27:38 > 0:27:42the teenage boy had shot him in the leg with a single barrel shotgun
0:27:42 > 0:27:46that had been sourced by Egeland himself.
0:27:46 > 0:27:49Unsurprisingly, news of Egeland's desperate attempt to escape jail
0:27:49 > 0:27:52made headlines across the USA.
0:27:52 > 0:27:54But ultimately, it made no difference to his fate.
0:27:54 > 0:27:59Egeland was taken into custody to begin his ten-year prison sentence,
0:27:59 > 0:28:04and was later charged with conspiracy to commit fraud.
0:28:04 > 0:28:07As shocking as it is that a man would go to such lengths to avoid
0:28:07 > 0:28:11jail whilst lining his own pocket at the same time,
0:28:11 > 0:28:14what's truly unbelievable are the depths that he sank to by
0:28:14 > 0:28:18implicating his own son in such a barbaric scheme.
0:28:26 > 0:28:27Still to come...
0:28:27 > 0:28:31A bus passenger has an appetite for compensation.
0:28:31 > 0:28:34This lady has alleged some quite serious soft tissue injuries.
0:28:34 > 0:28:36She didn't even know the impact had occurred.
0:28:43 > 0:28:44Now, when it comes to validating
0:28:44 > 0:28:48insurance claims, a simple rule of thumb is that if someone is genuine,
0:28:48 > 0:28:52then they should be able to accurately recall their experience
0:28:52 > 0:28:54and the facts surrounding it time and again.
0:28:54 > 0:28:58So when insurers are faced with claimants who give inconsistent
0:28:58 > 0:29:02accounts of what's happened, it can set alarm bells ringing -
0:29:02 > 0:29:05and, in some cases, with good reason.
0:29:10 > 0:29:13Travel insurance is one of those holiday
0:29:13 > 0:29:15essentials that you hope you won't need to use,
0:29:15 > 0:29:20but can save you a small fortune in the event that you do.
0:29:20 > 0:29:22Simon Cook works at CEGA,
0:29:22 > 0:29:26a Charles Taylor company that provides travel claim services.
0:29:26 > 0:29:28His team recently dealt with a case
0:29:28 > 0:29:29where a travelling football fan
0:29:29 > 0:29:33appeared to have scored an own goal.
0:29:34 > 0:29:38The customer told us that he had parked his vehicle up in Nice in
0:29:38 > 0:29:42France, as he was due to watch some football matches.
0:29:46 > 0:29:47And due to crowd troubles,
0:29:47 > 0:29:50unfortunately, the car had been broken into
0:29:50 > 0:29:53and he had his personal possessions stolen from inside the car.
0:30:09 > 0:30:13The trouble between fans at the tournament had been well documented on the news.
0:30:13 > 0:30:18We were fully aware that there had been crowd trouble associated with
0:30:18 > 0:30:22the football matches in France, and it was reasonable that the
0:30:22 > 0:30:24customer had driven his car to Nice, so, you know,
0:30:24 > 0:30:30we had no real reason to believe that this was anything other than a genuine claim.
0:30:30 > 0:30:32So far, so good...
0:30:32 > 0:30:36..although the customer was missing a vital piece of documentation.
0:30:36 > 0:30:38When dealing with crimes such as this,
0:30:38 > 0:30:40we do really need a written police
0:30:40 > 0:30:43report to substantiate the claim.
0:30:43 > 0:30:46But on this occasion, the customer told us that due to the crowd
0:30:46 > 0:30:49trouble, the police weren't able to assist him,
0:30:49 > 0:30:54and therefore we decided that we would look into the claim without a police report.
0:30:54 > 0:30:58The items being claimed for were a laptop and some clothing.
0:31:00 > 0:31:05However, it wasn't long before CEGA began to suspect foul play.
0:31:05 > 0:31:08We became suspicious with the claim because when we received the
0:31:08 > 0:31:10customer's claim information pack,
0:31:10 > 0:31:14he'd added an expensive camera and a watch to the claim,
0:31:14 > 0:31:19having not mentioned either of these items to us during the initial call,
0:31:19 > 0:31:23and even making reference to the fact that he didn't have any need to
0:31:23 > 0:31:25make a claim for any other items.
0:31:42 > 0:31:47We found it very hard to understand how the customer could recall such
0:31:47 > 0:31:50small items of clothing like T-shirts and jumpers,
0:31:50 > 0:31:54but he wasn't able to recall an expensive camera and a watch
0:31:54 > 0:31:56as well when, bar the laptop,
0:31:56 > 0:32:00these were the two most expensive items he was now claiming for.
0:32:11 > 0:32:15Hold on a minute. He just said that the back window had been smashed,
0:32:15 > 0:32:18but looking at the photo he submitted to back up his claim,
0:32:18 > 0:32:21that's clearly one of the front windows.
0:32:21 > 0:32:25And that wasn't the only thing that he'd got muddled up.
0:32:25 > 0:32:30We also noted that there was an address spray-painted to a wall in the photograph,
0:32:30 > 0:32:34so we decided to conduct some internet research on the address in question,
0:32:34 > 0:32:36and to our astonishment,
0:32:36 > 0:32:40the actual address was situated in Lille, and not Nice,
0:32:40 > 0:32:42where the customer said the incident had occurred.
0:32:43 > 0:32:45In case you're wondering,
0:32:45 > 0:32:50the distance between Lille and Nice is just over 700 miles -
0:32:50 > 0:32:52so, not exactly a minor mistake.
0:32:54 > 0:32:56With such whopping inconsistencies,
0:32:56 > 0:33:00one of Simon's investigators phoned the claimant to try and get some answers.
0:33:10 > 0:33:13At the outset of the call, customer told us the incident had in
0:33:13 > 0:33:15fact occurred in Lille and not Nice,
0:33:15 > 0:33:19which was different to what he told us during the initial call.
0:33:57 > 0:34:01He's not kidding. Thankfully, it's not every day most of us are victims
0:34:01 > 0:34:03of crime, so when it does happen,
0:34:03 > 0:34:07it's not something we're quick to forget the details of.
0:34:07 > 0:34:11But the inconsistencies just kept on coming.
0:34:20 > 0:34:25Whilst the phone call was going on, our investigator conducted some research
0:34:25 > 0:34:29and realised that where he was going was a considerable distance away
0:34:29 > 0:34:31from where he had parked his car.
0:35:02 > 0:35:05As if there weren't enough question marks with this claim already,
0:35:05 > 0:35:10our investigator then noted that the method of entry to the vehicle was
0:35:10 > 0:35:14completely different in the photograph to what the customer had actually told us.
0:35:25 > 0:35:27CLAIMANT: Erm...
0:35:37 > 0:35:41So, to recap - since the original call to report the loss,
0:35:41 > 0:35:44the location had changed from Nice to Lille.
0:35:44 > 0:35:48The items taken had changed from a laptop and clothes to a laptop,
0:35:48 > 0:35:49camera, watch and clothes.
0:35:49 > 0:35:52The distance from the stadium had changed from a ten minute walk to
0:35:52 > 0:35:55a seven and a half kilometre journey,
0:35:55 > 0:35:58and the window that had been smashed had changed from the back of the car
0:35:58 > 0:36:00to the driver's side.
0:36:00 > 0:36:06As inconsistencies go, these were textbook examples.
0:36:06 > 0:36:09We gave the customer the opportunity to provide us with reasonable
0:36:09 > 0:36:13explanations for the issues that we had unearthed with the claim.
0:36:13 > 0:36:15But unfortunately, he simply couldn't do that.
0:36:41 > 0:36:43It took a while, but eventually,
0:36:43 > 0:36:47the forgetful football fan said something that did make sense.
0:36:47 > 0:36:52However, CEGA had heard enough and promptly reached for the red card.
0:37:17 > 0:37:21If the claimant thought it was all over, it was now.
0:37:21 > 0:37:22In my experience,
0:37:22 > 0:37:25there is a misconception that low
0:37:25 > 0:37:28value fraudulent claims will not be investigated,
0:37:28 > 0:37:31but that is definitely not the case.
0:37:36 > 0:37:37Now, transport companies up and
0:37:37 > 0:37:41down the UK see all sorts of claims come in -
0:37:41 > 0:37:44many of which are genuine, and many that are not.
0:37:44 > 0:37:47But when it transpires that the event you're claiming for was so
0:37:47 > 0:37:50minor you didn't even know it happened,
0:37:50 > 0:37:52that really does take the biscuit.
0:37:56 > 0:38:00With over eight billion journeys made on public transport
0:38:00 > 0:38:04in the UK every year, the odd mishap is inevitable.
0:38:05 > 0:38:08First Group operates a fleet of over 6,000 buses,
0:38:08 > 0:38:11and when an incident happens on one of their vehicles,
0:38:11 > 0:38:15it usually lands on the desk of Lee Ingram.
0:38:15 > 0:38:21But as Lee knows all too well, not all claims are as they first appear.
0:38:21 > 0:38:25We received a report following an incident where a bus had hit another
0:38:25 > 0:38:28one in the rear, causing the windscreen to shatter.
0:38:31 > 0:38:32TYRES SCREECH
0:38:32 > 0:38:35CRASH
0:38:35 > 0:38:38The claim had come in from one of the passengers in the rear bus,
0:38:38 > 0:38:41saying that she had been injured as a result of this.
0:38:42 > 0:38:44Later on when she attended the hospital,
0:38:44 > 0:38:47she told them that she'd been thrown forwards and backwards,
0:38:47 > 0:38:50resulting in some soft tissue injuries
0:38:50 > 0:38:52severe enough to cause her to feel nauseous.
0:38:52 > 0:38:57So, yeah, a not insubstantial degree of physical injuries.
0:38:59 > 0:39:01With a smashed windscreen and no
0:39:01 > 0:39:04question as to whether or not the collision had taken place,
0:39:04 > 0:39:09Lee and his team began the process of settling the claim.
0:39:09 > 0:39:14Early indications would suggest that there were no real reasons to be concerned about the claim.
0:39:14 > 0:39:16We were satisfied an impact had occurred.
0:39:16 > 0:39:21We tend to take these things on face value until we've examined all the evidence.
0:39:22 > 0:39:25When it comes to evidence...
0:39:25 > 0:39:29First Group are fortunate enough to have the best.
0:39:29 > 0:39:33With multiple CCTV cameras and other hi-tech kit fitted to every bus,
0:39:33 > 0:39:38Lee and his team often have the luxury of calling upon the ultimate eyewitness.
0:39:40 > 0:39:44So as we watched the bus approach the stand, you're thinking, "Right,
0:39:44 > 0:39:47"in a minute the bus driver's going to slam his brakes on, then he's
0:39:47 > 0:39:49"going to hit the bus in front."
0:39:49 > 0:39:51All right.
0:39:51 > 0:39:54Here it comes. Any second now.
0:39:54 > 0:39:56Now?
0:39:58 > 0:39:59Hang on a minute!
0:40:02 > 0:40:06What we actually see is a very gradual slow down,
0:40:06 > 0:40:09and the mirror arm just pushes up against
0:40:09 > 0:40:11the window of the bus in front,
0:40:11 > 0:40:13causing it to break.
0:40:14 > 0:40:18It's designed to do that when you apply pressure on it -
0:40:18 > 0:40:20a fair amount of pressure, mind you.
0:40:20 > 0:40:22But you can see that the driver's
0:40:22 > 0:40:25just distraught, "What have I done, what's happened there?"
0:40:25 > 0:40:27It's hardly the chassis-crushing carnage
0:40:27 > 0:40:29this woman's account suggested.
0:40:30 > 0:40:35Fortunately, First Group CCTV cameras have all the angles covered,
0:40:35 > 0:40:38so perhaps the camera covering the claimant herself
0:40:38 > 0:40:39would be more conclusive.
0:40:41 > 0:40:47We then look at the lady in question just to see how much this alleged
0:40:47 > 0:40:50jolt or impact could have affected her.
0:40:50 > 0:40:52Was she thrown forward and backwards in her seat?
0:40:53 > 0:40:54The answer to that question...
0:40:56 > 0:40:57..is plain to see.
0:40:57 > 0:41:00All she's really doing is eating,
0:41:00 > 0:41:02and eating, and eating.
0:41:02 > 0:41:07In fact, she didn't even know the impact had occurred.
0:41:10 > 0:41:12HARP MUSIC
0:41:12 > 0:41:15Blissfully unaware that anything's happened,
0:41:15 > 0:41:19the CCTV wasn't exactly backing up the woman's claim.
0:41:21 > 0:41:25This footage clearly shows that there were certainly no forces that
0:41:25 > 0:41:29acted upon this claimant causing her to have sustained those injuries.
0:41:31 > 0:41:33It appeared that in addition to baked goods,
0:41:33 > 0:41:36this woman also had an appetite for compensation,
0:41:36 > 0:41:39regardless of whether or not she was entitled to it.
0:41:39 > 0:41:43It's disappointing to note that people still
0:41:43 > 0:41:45will make claims like this.
0:41:45 > 0:41:49I mean, in this instance, when you watch the incident unfurl,
0:41:49 > 0:41:53it's some time after the actual impact she does look up,
0:41:53 > 0:41:56and then she thinks, "Oh, something's happened."
0:41:56 > 0:41:58She didn't know it had happened until she
0:41:58 > 0:42:00actually looked up from her pie.
0:42:00 > 0:42:05As far as Lee was concerned, a pay-out was definitely off the menu.
0:42:05 > 0:42:09And the only pie the claimant would be eating after this was humble pie.
0:42:09 > 0:42:12We repudiated the claim in full, and
0:42:12 > 0:42:15we haven't heard back from them since.
0:42:15 > 0:42:16Lee and his team had successfully
0:42:16 > 0:42:19scuppered yet another spurious claim.
0:42:19 > 0:42:21But no matter how many he deals with,
0:42:21 > 0:42:24Lee knows full well this won't be the last.
0:42:26 > 0:42:30When we look at footage of this nature and we see that someone's
0:42:30 > 0:42:35clearly making up circumstances to fit a potential claim,
0:42:35 > 0:42:39it sort of makes you disappointed in people's nature.
0:42:39 > 0:42:42Why would they think that this is the right thing to do?
0:42:42 > 0:42:44There are times when people will be injured,
0:42:44 > 0:42:48and if there weren't so many of these people wasting our time,
0:42:48 > 0:42:50we would be able to give our attention
0:42:50 > 0:42:52more to those more deserving.
0:42:58 > 0:43:02From organised criminal gangs to exaggerated household claims,
0:43:02 > 0:43:05insurance fraud hits all of us in the pocket.
0:43:05 > 0:43:07But instead of getting away with it,
0:43:07 > 0:43:11more and more of these fraudsters are being claimed and shamed.