0:00:06 > 0:00:09Insurance fraud in the UK has hit epidemic levels.
0:00:10 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:18That's almost £3.6 million every day.
0:00:20 > 0:00:26Deliberate crashes, bogus personal injuries, even phantom pets.
0:00:26 > 0:00:30The fraudsters are risking more and more to make a quick killing
0:00:30 > 0:00:33and every year it's adding around £50 to your insurance bill.
0:00:33 > 0:00:36But insurers are fighting back,
0:00:36 > 0:00:38exposing just under 15 fake claims every hour.
0:00:40 > 0:00:42Armed with covert surveillance systems...
0:00:42 > 0:00:45Subject, out of the vehicle.
0:00:45 > 0:00:49..sophisticated data analysis techniques...
0:00:49 > 0:00:52- Police! - And a number of highly skilled police units...
0:00:52 > 0:00:54Police! Don't move, stay where you are.
0:00:54 > 0:00:56..they are catching the criminals red-handed.
0:00:56 > 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 > 0:01:03are now caught in the act
0:01:03 > 0:01:06and Claimed And Shamed.
0:01:10 > 0:01:14Today... Modern technology is the undoing of
0:01:14 > 0:01:17an opportunistic fraudster.
0:01:17 > 0:01:20We were able to review the metadata and we found that the images had
0:01:20 > 0:01:23actually been produced nearly two weeks after
0:01:23 > 0:01:25they were reported as stolen.
0:01:25 > 0:01:28A claim for stolen luggage is lost in translation.
0:01:29 > 0:01:33Our Italian colleague told us that the words used were more in line
0:01:33 > 0:01:36with someone taking the words off an internet translation service.
0:01:38 > 0:01:41And justice is served on a gang who made the mistake of thinking
0:01:41 > 0:01:45insurance fraud is easy money.
0:01:45 > 0:01:47It is the most ill-planned,
0:01:47 > 0:01:49the most badly thought through
0:01:49 > 0:01:51enterprise probably that's been caught on
0:01:51 > 0:01:53camera in a case of this type.
0:01:57 > 0:01:59Being burgled is an awful experience.
0:01:59 > 0:02:03Knowing that a stranger has been in your home is one thing but when
0:02:03 > 0:02:07irreplaceable possessions are taken, that really hurts.
0:02:07 > 0:02:08Now, whilst an insurance policy
0:02:08 > 0:02:11can't cover the loss of sentimental items,
0:02:11 > 0:02:15it can provide reimbursement to pay for the things that can be replaced.
0:02:15 > 0:02:19However, not all burglary claims are as they first appear.
0:02:23 > 0:02:28With almost 700,000 burglaries a year in England and Wales alone,
0:02:28 > 0:02:31it's one of the most common home insurance claims.
0:02:32 > 0:02:35However, it is also one of the types of insurance that sees more than its
0:02:35 > 0:02:40fair share of grossly exaggerated or opportunistic claims.
0:02:40 > 0:02:42Lloyds Banking Group dealt with a
0:02:42 > 0:02:44claim from one of their policyholders,
0:02:44 > 0:02:48a Mr Field who had been unfortunate enough to become another victim of
0:02:48 > 0:02:51this terrible crime.
0:02:51 > 0:02:52A customer reported that when he
0:02:52 > 0:02:55returned home from work around lunchtime,
0:02:55 > 0:02:58he found that his front door had either been jemmied or kicked in.
0:02:59 > 0:03:01He went into the house and he found
0:03:01 > 0:03:03that most of the rooms in the home had
0:03:03 > 0:03:07been ransacked and that a number of items had been stolen.
0:03:35 > 0:03:41Unfortunately for Mr Field, the thieves had expensive taste.
0:03:41 > 0:03:43Multiple items had been stolen,
0:03:43 > 0:03:46primarily jewellery and there was a mixture of ladies' jewellery,
0:03:46 > 0:03:50gentlemen's jewellery, children's jewellery.
0:03:50 > 0:03:53The customer was particularly upset that some of his late parents'
0:03:53 > 0:03:57jewellery had gone missing, including their wedding rings.
0:03:57 > 0:03:59Other items that were reported,
0:03:59 > 0:04:03there was a vintage Omega watch, laptops,
0:04:03 > 0:04:06an iPad and a mobile phone.
0:04:06 > 0:04:12The estimated value of the items stolen was approximately £17,000.
0:04:12 > 0:04:17It was a considerably large claim but as far as Lloyds were concerned,
0:04:17 > 0:04:19nothing to worry about.
0:04:19 > 0:04:22When we first received the claim, everything appeared in order.
0:04:22 > 0:04:27The description of the items and the description of the nature of damage
0:04:27 > 0:04:29appeared that a burglary had in fact happened.
0:04:46 > 0:04:49Keen to get Mr Field and his family back to normality,
0:04:49 > 0:04:52Lloyds began to process the claim.
0:04:52 > 0:04:53As part of reviewing the claim,
0:04:53 > 0:04:57we always ask and work with our customers to help us understand the
0:04:57 > 0:05:00value of the items, give us some descriptions of them,
0:05:00 > 0:05:03details of their age, where they acquired them.
0:05:03 > 0:05:05Types of evidence that they can help us to
0:05:05 > 0:05:09validate the claim would include things like receipt, manuals,
0:05:09 > 0:05:13boxes perhaps, any valuations on jewellery,
0:05:13 > 0:05:16but also photographic evidence as well that they can provide us with,
0:05:16 > 0:05:21just to get an idea of the type of goods and their descriptions.
0:05:21 > 0:05:23It was at this point in the claims
0:05:23 > 0:05:26process that things began to unravel.
0:05:26 > 0:05:31When we received some photographic evidence relating to items of
0:05:31 > 0:05:33jewellery that had been reported stolen,
0:05:33 > 0:05:38we were able to review the metadata that sits behind those digital
0:05:38 > 0:05:40photographs and we found that
0:05:40 > 0:05:4312 of the images had actually been produced
0:05:43 > 0:05:46nearly two weeks after they were reported as stolen.
0:05:47 > 0:05:52Metadata is the information that is attached to every digital photo and
0:05:52 > 0:05:54most crucially for insurers,
0:05:54 > 0:05:56it includes the date that the photo was taken.
0:05:56 > 0:06:00So, when they receive photos that were taken after the items were
0:06:00 > 0:06:04allegedly stolen, it begs the question,
0:06:04 > 0:06:06"Were they ever stolen at all?".
0:06:06 > 0:06:09Understandably, Lloyds wanted some answers.
0:06:10 > 0:06:13Once we had identified that there were potential challenges over the
0:06:13 > 0:06:17photographs and how genuine the burglary was,
0:06:17 > 0:06:20we arranged one of our agents to meet with the customer.
0:06:20 > 0:06:25We explained to him that we had some concerns about how the photographs
0:06:25 > 0:06:28had been produced and provided to us.
0:06:28 > 0:06:30The customer explained to us that he
0:06:30 > 0:06:32had actually used a memory stick that
0:06:32 > 0:06:35he had found in the property because the photographs were originally
0:06:35 > 0:06:39contained on a laptop which had been stolen.
0:06:39 > 0:06:43He then used the memory stick in one of his friend's laptops and he
0:06:43 > 0:06:47downloaded those images onto the laptop and then transferred them
0:06:47 > 0:06:50onto his mobile phone and then supplied them to us.
0:06:50 > 0:06:51He maintained that the
0:06:51 > 0:06:55photographs had not been taken after the burglary.
0:06:55 > 0:06:59Mr Field may have thought he had a rational explanation but as Dave
0:06:59 > 0:07:03explains, the information embedded in the photos was from the date they
0:07:03 > 0:07:07were taken, regardless of how many times they had been copied on to
0:07:07 > 0:07:09different devices.
0:07:09 > 0:07:12It didn't make any sense to us at the time
0:07:12 > 0:07:14because the metadata behind the digital photographs
0:07:14 > 0:07:17was still showing that they were taken nearly
0:07:17 > 0:07:20two weeks after the reported burglary.
0:07:20 > 0:07:24So not only had the customer lied about the £17,000 worth
0:07:24 > 0:07:26of possessions that had been stolen,
0:07:26 > 0:07:28but he had then taken photographs of the items
0:07:28 > 0:07:33a substantial time after the alleged burglary and then he lied again,
0:07:33 > 0:07:37to try and cover up the real date the photos were taken.
0:07:37 > 0:07:41With discrepancies as big as those, there was only one conclusion.
0:07:43 > 0:07:47As a result of the inquiries we completed and a lack of explanation
0:07:47 > 0:07:50that was plausible to us by the customer,
0:07:50 > 0:07:54we declined the claim and we cancelled the policy invoking the
0:07:54 > 0:07:56fraud condition.
0:07:56 > 0:08:00But Lloyds weren't prepared to leave the case there.
0:08:00 > 0:08:02We reported the matter to the
0:08:02 > 0:08:04Insurance Fraud Enforcement Department
0:08:04 > 0:08:07and charges were brought against the customer to which he pleaded guilty.
0:08:07 > 0:08:11He was required to reimburse the monies that we had already paid him
0:08:11 > 0:08:14in part settlement of the claim. He was also fined £200.
0:09:04 > 0:09:09With over £1,500 for the part settlement plus the fine of £200,
0:09:09 > 0:09:12this guy will be paying back his debts for long time,
0:09:12 > 0:09:16making him rue the day he tried to defraud his insurance company.
0:09:16 > 0:09:21The vast majority of claims that we deal with are genuine in origin.
0:09:21 > 0:09:26Unfortunately, a limited number of those claims are either fictitious
0:09:26 > 0:09:28or they are exaggerated but we
0:09:28 > 0:09:30remain committed to identifying those claims
0:09:30 > 0:09:33and only paying the honest and genuine ones.
0:09:40 > 0:09:42Later...
0:09:42 > 0:09:44In the USA, the woman who was prepared to
0:09:44 > 0:09:46kill her own husband for money.
0:09:47 > 0:09:52And time is called on a personal injury claim, thanks to CCTV.
0:09:52 > 0:09:56There is no evidence here that the shutters fell on him as he walked
0:09:56 > 0:09:57through the doors.
0:09:57 > 0:10:00This suggests that, in fact, there was no accident.
0:10:05 > 0:10:09Travelling abroad can be a stressful experience.
0:10:09 > 0:10:12Not only have you got all your luggage but you are also constantly
0:10:12 > 0:10:14having to get things in and out of your bag,
0:10:14 > 0:10:16like your passport, boarding pass,
0:10:16 > 0:10:19hotel details, currency...
0:10:19 > 0:10:21You get the idea. With so much going on,
0:10:21 > 0:10:25it's easy to misplace a few things and that's where a travel insurance
0:10:25 > 0:10:27policy can come into its own.
0:10:33 > 0:10:34Despite the stress,
0:10:34 > 0:10:39for most of us going on holiday is a real treat we look forward to.
0:10:41 > 0:10:44And something we want to be able to look back on,
0:10:45 > 0:10:48so a camera is crucial.
0:10:49 > 0:10:54But carrying one around with you can be a precarious business.
0:10:55 > 0:10:57CEGA is a Charles Taylor company
0:10:57 > 0:10:59that provides travel claims services.
0:10:59 > 0:11:02But as their head of technical claims explains,
0:11:02 > 0:11:06not every claim they deal with is entirely above board.
0:11:11 > 0:11:13Whilst on holiday in Italy,
0:11:13 > 0:11:17the customer was taking a taxi and when he disembarked from the taxi,
0:11:17 > 0:11:20he accidentally left his camera bag in the vehicle.
0:11:55 > 0:11:58Now I am not sure that is strictly true.
0:11:58 > 0:12:00Ordinarily, we would expect the
0:12:00 > 0:12:02customer to provide us with a police report
0:12:02 > 0:12:04to support the claim. On this occasion,
0:12:04 > 0:12:07he had been to the police station and it was closed.
0:12:07 > 0:12:10So, according to the claimant, not only is Italy in
0:12:10 > 0:12:11a state of disrepair,
0:12:11 > 0:12:15but the police stations are closed too.
0:12:15 > 0:12:18Fortunately for him, CEGA are prepared to accept
0:12:18 > 0:12:20an alternative to a police statement.
0:12:52 > 0:12:56So, that is precisely what the claimant did.
0:12:56 > 0:12:59When the claim documentation was received,
0:12:59 > 0:13:00we noted that the customer
0:13:00 > 0:13:02had provided us with a copy of the receipt
0:13:02 > 0:13:05for the camera and a loss report which was
0:13:05 > 0:13:08from the taxi company in Italy.
0:13:09 > 0:13:12Due to the international nature of our business,
0:13:12 > 0:13:16we have a lot of linguists that work within CEGA and on this occasion,
0:13:16 > 0:13:20we passed the loss report over to an Italian speaker.
0:13:20 > 0:13:23But the translation of the letter wasn't quite what Simon
0:13:23 > 0:13:26and his team had been expecting.
0:13:26 > 0:13:29Our Italian colleague told us that the words used within
0:13:29 > 0:13:31the loss report didn't appear to
0:13:31 > 0:13:34have been written by an Italian national.
0:13:34 > 0:13:36They were more in line with someone taking the words off
0:13:36 > 0:13:40an internet translation service.
0:13:40 > 0:13:43Unless the taxi company was employing backpackers looking to
0:13:43 > 0:13:47improve their Italian, the poor language used in the letter was
0:13:47 > 0:13:50a real cause for concern.
0:13:50 > 0:13:52As a result of the issues with the loss report,
0:13:52 > 0:13:57our Italian colleague contacted the taxi company in question to discuss
0:13:57 > 0:14:00whether the loss report originated from them.
0:14:01 > 0:14:04But rather than allaying any concerns with the claim,
0:14:04 > 0:14:08the phone call raised them even further.
0:15:12 > 0:15:15The outcome of the conversation was that the taxi company
0:15:15 > 0:15:17had never even heard of the customer,
0:15:17 > 0:15:20nor had they issued this loss report.
0:15:20 > 0:15:23So had something been lost in translation or was this claim
0:15:23 > 0:15:26just a load of baloney?
0:15:26 > 0:15:30It was at this point that the entire claim's validity was called into
0:15:30 > 0:15:34question because we didn't understand how the customer could have obtained
0:15:34 > 0:15:38a loss report from this taxi company when they had no record of him.
0:15:38 > 0:15:43There was only one way Simon and his team were going to get any answers.
0:15:43 > 0:15:47We decided that we needed to discuss these concerns with the customer
0:15:47 > 0:15:48because, at this point,
0:15:48 > 0:15:52we thought there might be some form of explanation he could provide.
0:16:49 > 0:16:52Finally, the truth had come out.
0:16:52 > 0:16:56Although the next part of this tale is slightly easier to predict.
0:16:56 > 0:17:00This explanation was also not accepted because the bottom line was
0:17:00 > 0:17:03the taxi company had no record of this incident.
0:17:05 > 0:17:08You would be hardly surprised to hear that we weren't prepared to
0:17:08 > 0:17:12accept the claim and the claim was declined in full.
0:18:02 > 0:18:05Despite the forged loss report and numerous versions of events,
0:18:05 > 0:18:09Simon and his team had exposed the allegedly stolen camera as a
0:18:09 > 0:18:11clumsy attempt to cash in.
0:18:11 > 0:18:16We prove on a daily basis that travel insurance is not
0:18:16 > 0:18:18an easy target for fraudsters.
0:18:18 > 0:18:22And we will go to great lengths to investigate claims.
0:18:28 > 0:18:30Now, whiplash injuries have become
0:18:30 > 0:18:32synonymous with car insurance claims,
0:18:32 > 0:18:37so much so that many people are under the misconception that simply
0:18:37 > 0:18:41being involved in a car accident, regardless of how it happened,
0:18:41 > 0:18:43automatically gives them the right to make a personal injury claim,
0:18:43 > 0:18:47citing whiplash as the reason.
0:18:47 > 0:18:49Well, as this next story demonstrates,
0:18:49 > 0:18:51that simply isn't the case.
0:18:56 > 0:19:00For many of us, buses are an essential form of transport.
0:19:02 > 0:19:04But for some unscrupulous individuals,
0:19:04 > 0:19:06they're a target for bogus insurance claims.
0:19:10 > 0:19:14Law firm Keoghs recently dealt with a case on behalf of Key Claims And
0:19:14 > 0:19:16Administration Services,
0:19:16 > 0:19:20which turned out to be an organised personal injury fraud on an
0:19:20 > 0:19:23unprecedented scale.
0:19:23 > 0:19:26There was a double-decker bus doing its usual routes
0:19:26 > 0:19:29from Pontefract to Wakefield.
0:19:32 > 0:19:36And during the course of that route, unusually,
0:19:36 > 0:19:3919 people got on a bus at Ferrybridge
0:19:39 > 0:19:42when normally nobody gets on the bus at Ferrybridge.
0:19:44 > 0:19:46And during the course of the journey,
0:19:46 > 0:19:50the bus was hit in the rear by a Nissan Micra.
0:19:52 > 0:19:54Very quickly after that,
0:19:54 > 0:19:59every one of the passengers who got on the bus intimated a claim against
0:19:59 > 0:20:01the insurers of the Micra.
0:20:03 > 0:20:05So it seems pretty straightforward.
0:20:05 > 0:20:09The passengers were injured in the collision which was clearly the
0:20:09 > 0:20:12car's fault and decided to claim compensation.
0:20:12 > 0:20:17Our estimated value of the total claims was around £140,000
0:20:17 > 0:20:19so a very significant sum.
0:20:19 > 0:20:21If those claims had moved into litigation and solicitors had been
0:20:21 > 0:20:24involved on both sides to defend the claims,
0:20:24 > 0:20:28then you're talking about a quarter of a million or more.
0:20:28 > 0:20:33All in, it was a pretty hefty set of claims but as the passengers were
0:20:33 > 0:20:36saying they'd been badly injured, it all seemed to stack up.
0:20:36 > 0:20:39Nevertheless, there was something about the accident that just
0:20:39 > 0:20:42didn't seem right.
0:20:42 > 0:20:45What was unusual about it was the number of claims that were made and
0:20:45 > 0:20:48the speed with which they were made.
0:20:48 > 0:20:50They contacted the bus company who
0:20:50 > 0:20:53gave them the CCTV footage of the accident.
0:20:57 > 0:21:01You can see everybody getting on the bus, all 19 piling on.
0:21:03 > 0:21:06How they get on is quite noticeable, you know, this is not a quiet,
0:21:06 > 0:21:09shy and retiring bunch of people, as you can see.
0:21:09 > 0:21:12How they're dressed is very distinctive.
0:21:12 > 0:21:14Taste in clothes aside,
0:21:14 > 0:21:17it was once the group had boarded the bus that their action seemed a
0:21:17 > 0:21:19little suspicious.
0:21:19 > 0:21:22You'll see that there's a degree of preparation,
0:21:22 > 0:21:24what appears to be preparation going on.
0:21:24 > 0:21:28For example, there's somebody looking out of the back window and
0:21:28 > 0:21:31they seem to be looking out, signalling.
0:21:31 > 0:21:34There's a Nissan Micra that catches up to the bus and then spends a
0:21:34 > 0:21:37couple of miles, actually, trying to keep pace with the bus
0:21:37 > 0:21:39in a quite comical situation.
0:21:40 > 0:21:44But there was nothing funny about what happened next.
0:21:49 > 0:21:54From the passengers' reactions, it looked like a significant crash.
0:21:54 > 0:21:57Then Damien spotted something unusual.
0:21:59 > 0:22:02If you look at the paper cup here...
0:22:06 > 0:22:08It doesn't move at all on impact.
0:22:09 > 0:22:11And yet you'll see one of the
0:22:11 > 0:22:15defendants flings themselves forward as if
0:22:15 > 0:22:17they've been catapulted out of their seat
0:22:17 > 0:22:18by a really significant collision.
0:22:20 > 0:22:22Something definitely wasn't right.
0:22:22 > 0:22:24Just have a look at this honest
0:22:24 > 0:22:26passenger who had nothing to do with the fraud.
0:22:26 > 0:22:29While the gang are all holding their necks,
0:22:29 > 0:22:31this passenger doesn't seem
0:22:31 > 0:22:35aware that anything has happened to the bus.
0:22:35 > 0:22:37As you will see, the occupants of
0:22:37 > 0:22:39the top deck start to pile downstairs,
0:22:39 > 0:22:41holding their necks.
0:22:41 > 0:22:45Rubbing their shoulders in a comical and laughable way.
0:22:45 > 0:22:49First, they get off, come past the driver.
0:22:49 > 0:22:51One of the defendants actually stole
0:22:51 > 0:22:54three £5 notes from the driver's cab,
0:22:54 > 0:22:57which was outrageous.
0:22:57 > 0:23:00This contortionist certainly doesn't paint the picture of someone that
0:23:00 > 0:23:02has just been injured in a crash.
0:23:02 > 0:23:04The driver was threatened.
0:23:04 > 0:23:06It was a very unpleasant incident.
0:23:07 > 0:23:10It appeared that making money was their ultimate aim,
0:23:10 > 0:23:14either by robbing the bus driver or by staging a fraudulent accident.
0:23:15 > 0:23:18Then they all go outside and here is the other thing,
0:23:18 > 0:23:22the cameras show that not one of the people on the bus goes to speak to
0:23:22 > 0:23:25the driver of the Nissan. Either to ask if they are all right or to
0:23:25 > 0:23:28remonstrate with them, which is what you would do. If the driver of a car
0:23:28 > 0:23:31had hit the back of the bus you were on, and you had been injured,
0:23:31 > 0:23:34you wouldn't speak to the driver of the bus, who is innocent,
0:23:34 > 0:23:37you would speak to the driver of the other car.
0:23:37 > 0:23:41Everything about the footage pointed towards this being a planned
0:23:41 > 0:23:43collision and it was no coincidence
0:23:43 > 0:23:45that every single member of the group
0:23:45 > 0:23:48claimed for soft tissue injuries to the neck, back and shoulders,
0:23:48 > 0:23:51otherwise known as whiplash.
0:23:51 > 0:23:55To see this level of injuries, this volume of injuries,
0:23:55 > 0:24:00you would normally expect for it to be a really quite significant
0:24:00 > 0:24:04accident. Not a minor tap in rear, which is what this was.
0:24:04 > 0:24:06Through investigation,
0:24:06 > 0:24:09law firm Keoghs were able to link the people in the Nissan Micra with
0:24:09 > 0:24:13the claimants on the bus, suggesting this was no accident.
0:24:14 > 0:24:19It quickly became clear they had failed to admit they had any
0:24:19 > 0:24:22connection to each other.
0:24:22 > 0:24:27When insurers spoke to the driver of the Nissan,
0:24:27 > 0:24:29no pre-accident associations where admitted.
0:24:29 > 0:24:31In fact, they were denied.
0:24:31 > 0:24:34And the reason that that's significant is because
0:24:34 > 0:24:38they don't want us to know that they're all in it together.
0:24:38 > 0:24:41They want it to look like an innocent accident.
0:24:42 > 0:24:46With all the evidence gathered, the case proceeded to court.
0:24:46 > 0:24:50But this lot weren't prepared to give up just yet.
0:24:51 > 0:24:55Various attempts were made by defendants through their barristers
0:24:55 > 0:24:58to strike out parts of the evidence.
0:24:58 > 0:25:00Various attempts to say, in fact,
0:25:00 > 0:25:03that they had no knowledge of these claims,
0:25:03 > 0:25:06that they'd been contacted by a claims management company and that
0:25:06 > 0:25:08the claims had been advanced on
0:25:08 > 0:25:11their behalf without their knowledge.
0:25:11 > 0:25:15It was unbelievable the lengths these cheats would go to to get away
0:25:15 > 0:25:18with it. But with the substantial evidence that had been gathered,
0:25:18 > 0:25:20the judge wasn't taking any nonsense.
0:25:22 > 0:25:27During the course of the case, the judge, having seen the CCTV footage,
0:25:27 > 0:25:30described the acting on the bus as bizarre and pathetic,
0:25:30 > 0:25:32and, paraphrasing what the judge said,
0:25:32 > 0:25:34that it was clear that they all knew
0:25:34 > 0:25:37what was going on. That they were all in it together.
0:25:37 > 0:25:41And that they were all therefore, in that sense, equally culpable.
0:25:41 > 0:25:43In the end, these fraudsters realised
0:25:43 > 0:25:45they had no choice but to give in.
0:25:45 > 0:25:48And every single one of them pleaded guilty.
0:25:48 > 0:25:52However, the judge was determined to make an example of them.
0:25:52 > 0:25:56Custodial sentences of 29 years and four months were handed down,
0:25:56 > 0:26:00and the vast majority of those sentences were immediate custodial
0:26:00 > 0:26:04sentences of up to two-and-a-half years.
0:26:04 > 0:26:08And this was a real shock for these defendants.
0:26:08 > 0:26:10All of the gang were sentenced,
0:26:10 > 0:26:15with the longest jail term going to Stephen Sankey, who got 21 months.
0:26:15 > 0:26:19David Southern, the gang member who also stole money from the driver's
0:26:19 > 0:26:21cab, got 18 months.
0:26:22 > 0:26:25And Richard Harper, the driver of the Micra,
0:26:25 > 0:26:29got 12 months and was disqualified from driving for three years.
0:26:29 > 0:26:34Ultimately, it was a diabolically poor attempt to swindle money out of
0:26:34 > 0:26:37an insurance company by deliberately causing an accident.
0:26:37 > 0:26:40And, once again, those caught cheating the system
0:26:40 > 0:26:42have been rumbled.
0:26:43 > 0:26:47When you look at it in the round, it is the most ill-planned,
0:26:47 > 0:26:50the most badly thought through enterprise probably that's been
0:26:50 > 0:26:54caught on camera in a case of this type. It's pathetic.
0:26:54 > 0:26:56No BAFTAs for this lot, no.
0:27:01 > 0:27:05Now, for many of us, heading down to the pub is a British tradition.
0:27:05 > 0:27:07In my humble opinion,
0:27:07 > 0:27:09catching up with a few friends and having a couple of drinks can be a
0:27:09 > 0:27:13fantastic way to unwind at the end of the day.
0:27:13 > 0:27:16But the last thing any of us expect when popping down the local is to
0:27:16 > 0:27:19sustain a serious injury.
0:27:23 > 0:27:28Nowadays, CCTV cameras can be seen pretty much everywhere.
0:27:30 > 0:27:31On buses,
0:27:31 > 0:27:33trains,
0:27:33 > 0:27:36on the high street,
0:27:36 > 0:27:39and also in pubs and bars up and down the country.
0:27:41 > 0:27:45These all-seeing eyes can be the difference in cases where it's one
0:27:45 > 0:27:48person's word against another's.
0:27:48 > 0:27:52Leandro Kelly is part of the JD Wetherspoon legal department
0:27:52 > 0:27:56and knows all too well how important CCTV can be.
0:28:00 > 0:28:04We received a claim for compensation from a customer who says that,
0:28:04 > 0:28:06while he was walking through the doors of our pub,
0:28:06 > 0:28:10the door shutter system activated and hit him in his head.
0:28:10 > 0:28:14The claimant said that he had bruises to his neck and his back and
0:28:14 > 0:28:19that he also lost his balance as a result of the accident.
0:28:19 > 0:28:21Now, depending on your tipple,
0:28:21 > 0:28:23it isn't unreasonable to expect
0:28:23 > 0:28:26a sore head after visiting the local pub.
0:28:26 > 0:28:29However, this poor chap hadn't even had a drink.
0:28:30 > 0:28:36The claim was valued up to £5,000 for physical injury and the claimant
0:28:36 > 0:28:40also claimed the cost of care that he received because of his injuries.
0:28:41 > 0:28:44So a nasty and unfortunate accident.
0:28:44 > 0:28:48But nothing to set alarm bells ringing.
0:28:48 > 0:28:52The claim had all the hallmarks of a genuine claim.
0:28:52 > 0:28:53The claimant instructed his solicitors
0:28:53 > 0:28:56the same month that the accident took place.
0:28:56 > 0:28:59And he also was medically examined a few months after that.
0:28:59 > 0:29:02So we thought that this would be a fairly straightforward case,
0:29:02 > 0:29:05although we know we had to investigate it further.
0:29:05 > 0:29:09However, when JD Wetherspoon looked into the circumstances of the
0:29:09 > 0:29:13accident, a rather interesting discrepancy cropped up.
0:29:13 > 0:29:16The first thing we did was to speak to the pub.
0:29:16 > 0:29:17We spoke to the pub manager,
0:29:17 > 0:29:20because if this involved a part of the premises that was defective or
0:29:20 > 0:29:23wasn't working, we needed to make sure that he or she was aware of it
0:29:23 > 0:29:26and whether or not they had taken steps to remedy it.
0:29:26 > 0:29:29And if, in fact, they were aware of the incident happening because of
0:29:29 > 0:29:32this. When we spoke to our staff members,
0:29:32 > 0:29:36they did recall that this customer came up and said that he had almost
0:29:36 > 0:29:40been hit. But when we received the claimant's actual claim form,
0:29:40 > 0:29:44he said that he had been hit by the shutters.
0:29:45 > 0:29:48Well, if you've almost been hit, then you have no claim.
0:29:48 > 0:29:52But if you had been hit, you do have claim.
0:29:52 > 0:29:56What had initially appeared to be a routine claim was beginning to sound
0:29:56 > 0:29:58rather suspicious.
0:29:58 > 0:30:02For customer safety, JD Wetherspoon pubs are fitted with CCTV cameras.
0:30:02 > 0:30:07So perhaps they would know the answer to what really happened.
0:30:08 > 0:30:11Looking at the CCTV footage, I'd expect to see that,
0:30:11 > 0:30:14while the claimant was walking through the doors,
0:30:14 > 0:30:16the shutters activated and dropped on him.
0:30:16 > 0:30:19Yeah, that is what you would expect to see.
0:30:19 > 0:30:23The only problem is, the footage tells a slightly different story.
0:30:23 > 0:30:27No, your eyes aren't deceiving you, the claimant isn't there,
0:30:27 > 0:30:31because he didn't even pass through the doorway.
0:30:31 > 0:30:35There's no evidence yet that the shutters fell on him as he walked
0:30:35 > 0:30:39through the doors. This suggests that the accident doesn't happen as
0:30:39 > 0:30:42he says it happens. In fact, there was no accident.
0:30:43 > 0:30:48Immediately, JD Wetherspoon knew this was an open and shut case.
0:30:48 > 0:30:50Even if the shutters were falling,
0:30:50 > 0:30:53there wouldn't have been enough time for them to hit him because the
0:30:53 > 0:30:56shutters move so slow that, walking through the door,
0:30:56 > 0:30:58there would have been no contact.
0:30:59 > 0:31:03With crystal clear evidence that there was no accident and this was
0:31:03 > 0:31:05an opportunistic attempt,
0:31:05 > 0:31:09JD Wetherspoon were expecting this claim to be retracted.
0:31:09 > 0:31:13And significantly quicker than the shutters on their pub door.
0:31:13 > 0:31:16Based on all the evidence that we gathered,
0:31:16 > 0:31:21we invited the claimant's solicitor to withdraw the claim.
0:31:21 > 0:31:24The claimant's solicitor didn't withdraw the claim,
0:31:24 > 0:31:30so we made a formal application to court to ask the court to dismiss
0:31:30 > 0:31:35the claimant's claim, and also to make a finding that the claimant was
0:31:35 > 0:31:38being fundamentally dishonest in trying to make a
0:31:38 > 0:31:40personal injury claim where
0:31:40 > 0:31:42there was no evidence of an accident.
0:31:43 > 0:31:45By continuing to pursue his claim,
0:31:45 > 0:31:49the claimant was playing a dangerous game as the punishment for
0:31:49 > 0:31:53fundamental dishonesty is far more than a slap on the wrist.
0:31:54 > 0:31:57If someone is found fundamentally dishonest in court,
0:31:57 > 0:31:59it means that they were trying to make a claim simply to
0:31:59 > 0:32:02get compensation.
0:32:02 > 0:32:05It is taken very seriously by the court and the claimants can be
0:32:05 > 0:32:09ordered to pay all the cost of all of the court proceedings,
0:32:09 > 0:32:13including our costs.
0:32:13 > 0:32:16Luckily for the claimant, JD Wetherspoon called time
0:32:16 > 0:32:18on the court case.
0:32:18 > 0:32:21The claimant has now entered into a back payment plan where he's having
0:32:21 > 0:32:25to pay us back our costs in the amount of about £5,000.
0:32:26 > 0:32:30It seemed clear to us that this claimant was trying to make a quick
0:32:30 > 0:32:33buck but he learned a rather expensive lesson
0:32:33 > 0:32:35that insurance fraud doesn't pay.
0:32:42 > 0:32:43Still to come...
0:32:43 > 0:32:47..a woman attempts to claim compensation two and a half years
0:32:47 > 0:32:50after saying she was perfectly OK.
0:32:50 > 0:32:53This was a claim presented arising out of a road traffic accident.
0:32:53 > 0:32:56The claimant, in actual fact,
0:32:56 > 0:32:59presented no evidence to support her claim whatsoever.
0:33:04 > 0:33:06Now, on this programme,
0:33:06 > 0:33:09we try to highlight the depths that some fraudsters will sink to
0:33:09 > 0:33:12in order to get their hands on a pay-out.
0:33:12 > 0:33:14Quite frankly, it's unbelievable.
0:33:14 > 0:33:18But that's especially true in America, where everything is bigger.
0:33:18 > 0:33:21Over there, insurance fraud is estimated to cost a
0:33:21 > 0:33:25staggering 40 billion per year.
0:33:25 > 0:33:29But while many fraudsters will only go so far as telling lies,
0:33:29 > 0:33:32there are some who will stop at nothing if it means
0:33:32 > 0:33:34getting what they want.
0:33:47 > 0:33:48In Columbus, Indiana,
0:33:48 > 0:33:53Alan and Tammy Duval were the picture-perfect couple.
0:33:53 > 0:33:57After a whirlwind romance, they were married in just 12 weeks
0:33:57 > 0:33:59which, although not unusual,
0:33:59 > 0:34:03did spark concerns amongst some members of Alan's family.
0:34:03 > 0:34:05However, none of them could have possibly predicted
0:34:05 > 0:34:08the events that would unfold.
0:34:11 > 0:34:17On the 24th of August 2007, Tammy made an urgent 911 call.
0:34:17 > 0:34:21She told the operator she had returned home from work to find Alan
0:34:21 > 0:34:23dead in a chair in the back yard.
0:34:26 > 0:34:29Initially, it looked as though he had died of alcohol poisoning.
0:34:32 > 0:34:34But on closer inspection,
0:34:34 > 0:34:38it transpired Alan and Tammy weren't the happy couple they had once been.
0:34:40 > 0:34:44In fact, they had separated a few months earlier and Alan had warned
0:34:44 > 0:34:46his family that, if anything were to happen to him,
0:34:46 > 0:34:48they should be suspicious of Tammy.
0:34:49 > 0:34:53Following his death, Alan's family went straight to the police,
0:34:53 > 0:34:56who immediately requested an autopsy.
0:34:56 > 0:34:58The toxicology report said that
0:34:58 > 0:35:01Alan's blood had a morphine concentration
0:35:01 > 0:35:05of around 100 times that of a therapeutic dose.
0:35:06 > 0:35:09The same amount of morphine was also found to be missing from the
0:35:09 > 0:35:12nursing home where Tammy worked.
0:35:12 > 0:35:17But how had Alan ingested so much morphine without realising?
0:35:18 > 0:35:21It turned out that the evening before his death,
0:35:21 > 0:35:25Tammy had made Alan her infamous dirt pudding as a special treat,
0:35:25 > 0:35:29laced with the morphine she had stolen, it was a deadly dessert.
0:35:36 > 0:35:41But why would Tammy want her estranged husband dead?
0:35:41 > 0:35:45Investigations revealed that she had recently encouraged Alan to take out
0:35:45 > 0:35:50a 100,000 life-insurance policy.
0:35:50 > 0:35:52Tammy was the sole beneficiary.
0:35:53 > 0:35:56What made this sickening plot even worse
0:35:56 > 0:35:57was the policy had been obtained
0:35:57 > 0:35:59through an insurance agent that
0:35:59 > 0:36:01Tammy had been having an affair with.
0:36:03 > 0:36:07So not only had Tammy Duval killed her husband by giving him a lethal
0:36:07 > 0:36:12dose of morphine, but she had also taken out a life insurance policy so
0:36:12 > 0:36:15she could make a profit out of his death.
0:36:15 > 0:36:17And, as if that wasn't bad enough,
0:36:17 > 0:36:19she'd also been cheating on him the entire time.
0:36:22 > 0:36:24Following Alan's death,
0:36:24 > 0:36:27the insurance agent advised Tammy not to attempt to cash in the policy
0:36:27 > 0:36:30as Alan had died during the policy's grace period,
0:36:30 > 0:36:34and any claims would look suspicious.
0:36:34 > 0:36:39Tammy ignored him and submitted a claim for payment anyway.
0:36:39 > 0:36:42As the investigation continued,
0:36:42 > 0:36:44it was discovered that an ex-boyfriend
0:36:44 > 0:36:45of Tammy's had once claimed that
0:36:45 > 0:36:49she had tried to poison him with a tainted pudding as well.
0:36:50 > 0:36:54Tammy Duval was arrested and later charged with murder,
0:36:54 > 0:36:56six counts of insurance fraud, and
0:36:56 > 0:36:59three counts of obstruction of justice.
0:37:00 > 0:37:05She was sentenced to 61.5 years in prison.
0:37:06 > 0:37:09Although justice had been served,
0:37:09 > 0:37:12nothing can bring back the victim of this diabolical crime.
0:37:19 > 0:37:20Now, many of us will be familiar
0:37:20 > 0:37:22with the recorded message we hear when we
0:37:22 > 0:37:26phone an insurance company telling us that the call is being recorded.
0:37:26 > 0:37:30There are a number of reasons why insurers record phone calls,
0:37:30 > 0:37:34and this next case demonstrates one of the most important.
0:37:37 > 0:37:40BLM are a legal firm who represent many insurance companies.
0:37:42 > 0:37:45Naomi Grant is one of their fraud partners who
0:37:45 > 0:37:46recently dealt with a case
0:37:46 > 0:37:49that was two and a half years in the making.
0:37:49 > 0:37:53This was a claim presented arising out of a road traffic accident in
0:37:53 > 0:37:55December 2012.
0:38:00 > 0:38:04The defendant had been following the claimant out of the junction.
0:38:04 > 0:38:06She stopped suddenly and the defendant drove
0:38:06 > 0:38:09into collision with the rear of her vehicle.
0:38:11 > 0:38:15So a classic prang which was duly followed with a classic claim.
0:38:17 > 0:38:20Fairly straightforward claim in itself,
0:38:20 > 0:38:24the claim for vehicle damage and hire came in for just under £2,000.
0:38:26 > 0:38:28As a matter of course, the insurer
0:38:28 > 0:38:30got in touch with their policyholder.
0:38:30 > 0:38:32About four days after the accident,
0:38:32 > 0:38:38the insurance company telephoned the claimant to really just check she
0:38:38 > 0:38:42was OK and a standard question in that call was to ask the claimant
0:38:42 > 0:38:44whether she had suffered any injury.
0:39:16 > 0:39:20There were no suspicious circumstances at all, no concerns,
0:39:20 > 0:39:23and after the claimant had confirmed that she wasn't injured,
0:39:23 > 0:39:27the vehicle damage claim was quickly resolved and the matter closed down.
0:39:28 > 0:39:30Ordinarily, that would be the end of it.
0:39:32 > 0:39:34But not in this case.
0:39:34 > 0:39:36So it was really quite surprising
0:39:36 > 0:39:39to the insurance company when in May 2015,
0:39:39 > 0:39:43some 30 months after the initial accident,
0:39:43 > 0:39:47the insurance company were presented with a claims notification form in
0:39:47 > 0:39:51which the claimant alleged that she had suffered a whiplash injury which
0:39:51 > 0:39:54she claimed she was still suffering from and had been suffering from
0:39:54 > 0:39:56since the point of the accident.
0:39:56 > 0:40:01She also claimed that she had been referred by the hospital for an MRI
0:40:01 > 0:40:06scan and that the MRI had revealed that she had arthritis which the
0:40:06 > 0:40:10claimant was trying to say was directly related to the accident.
0:40:14 > 0:40:18So after initially confirming that she was absolutely fine,
0:40:18 > 0:40:20the woman was now claiming that,
0:40:20 > 0:40:24for the past two and a half years she had been in so much pain that it
0:40:24 > 0:40:28was having a huge impact on her life.
0:40:28 > 0:40:29That's some U-turn.
0:40:30 > 0:40:33These injuries would have been quite dramatic,
0:40:33 > 0:40:35would have affected her life quite significantly.
0:40:35 > 0:40:39To say that she was still suffering some two years after the accident.
0:40:39 > 0:40:42So you would expect the claimant to really go into evidence that,
0:40:42 > 0:40:46with medical reports, a copy of an MRI scan,
0:40:46 > 0:40:49so that's what the insurance company asked for.
0:40:49 > 0:40:51It's a fair assumption.
0:40:51 > 0:40:53But, of course, a full medical history
0:40:53 > 0:40:54wouldn't be a problem considering
0:40:54 > 0:40:57the numerous appointments the woman must have attended
0:40:57 > 0:40:59over the past two years.
0:41:01 > 0:41:05Despite her assertions of injury, the claimant, in actual fact,
0:41:05 > 0:41:08presented no evidence to support a claim whatsoever.
0:41:10 > 0:41:13It is really surprising that the claimant didn't present any evidence
0:41:13 > 0:41:16when given the opportunity to do so.
0:41:17 > 0:41:19Had somebody been genuinely injured,
0:41:19 > 0:41:22then you would fully expect them to
0:41:22 > 0:41:24freely attend for medical examinations
0:41:24 > 0:41:29and happily present the evidence to support their injury.
0:41:29 > 0:41:31So the fact that, in this claim,
0:41:31 > 0:41:34the claimant didn't present any of
0:41:34 > 0:41:36that evidence in itself speaks volumes.
0:41:38 > 0:41:43On the other hand, BLM did have one piece of rock solid evidence.
0:41:43 > 0:41:46That same phone call the insurance company had made
0:41:46 > 0:41:48four days after the accident.
0:41:56 > 0:41:59Faced with the evidence of her own voice,
0:41:59 > 0:42:02the claimant sensibly decided not to pursue the claim.
0:42:03 > 0:42:05The key to the successful defence of
0:42:05 > 0:42:06this claim really was that phone call
0:42:06 > 0:42:09made by the insurance company to the claimant
0:42:09 > 0:42:11four days after the accident.
0:42:11 > 0:42:14What appeared at the time to be a routine phone call and a
0:42:14 > 0:42:17routine line of questioning to ask
0:42:17 > 0:42:18whether the claimant had been injured,
0:42:18 > 0:42:22really proved so beneficial when it came to defeating a very spurious
0:42:22 > 0:42:25injury claim presented some 30 months later.
0:42:26 > 0:42:28For Naomi, exaggerated claims
0:42:28 > 0:42:31are something she is all too familiar with.
0:42:31 > 0:42:34Quite often, claims that come in late,
0:42:34 > 0:42:35people hope that enough time
0:42:35 > 0:42:38has passed that the claim just won't get queried.
0:42:38 > 0:42:42Unfortunately, that's not the case where claims are presented
0:42:42 > 0:42:44so long after the event.
0:42:44 > 0:42:47Insurance companies will look at those in a lot more detail,
0:42:47 > 0:42:50especially where there's no evidence presented
0:42:50 > 0:42:53to support the allegations that are made.
0:42:59 > 0:43:02From organised criminal gangs to exaggerated household claims,
0:43:02 > 0:43:06insurance fraud hits all of us in the pocket.
0:43:06 > 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.