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 > 0:00:22Deliberate crashes, bogus personal injuries,
0:00:22 > 0:00:24even phantom pets.
0:00:25 > 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 under just 15 fake claims every hour.
0:00:39 > 0:00:41Armed with covert surveillance systems...
0:00:41 > 0:00:44That's the subject out the vehicle.
0:00:44 > 0:00:47..sophisticated data analysis techniques...
0:00:47 > 0:00:48POLICE!
0:00:48 > 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 > 0:00:56Just 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.
0:01:12 > 0:01:16Suspicious car damage gives forensic investigators cause for concern.
0:01:17 > 0:01:20Our engineer alerted us to his concerns that the damage
0:01:20 > 0:01:24didn't seem to be consistent with the accident circumstances,
0:01:24 > 0:01:27and he suspected that the damage may have actually been exaggerated.
0:01:28 > 0:01:33A severe case of amnesia catches out a convicted criminal.
0:01:33 > 0:01:38He struggled as to whether he'd fallen down 12 steps or two steps.
0:01:38 > 0:01:40He was also in difficulties when presented with
0:01:40 > 0:01:43his medical and employment history.
0:01:43 > 0:01:47..and a puppy owner's failure to get his facts straight
0:01:47 > 0:01:49rings alarm bells.
0:01:49 > 0:01:52His father had categorically advised him that the puppy
0:01:52 > 0:01:54had injured itself at ten o'clock -
0:01:54 > 0:01:57that was well and truly after the policy had been set up.
0:02:02 > 0:02:06Fraudsters will often exaggerate the details of an accident, or the
0:02:06 > 0:02:09damage caused to their vehicle, in order to try and get more money out
0:02:09 > 0:02:11of their insurance company.
0:02:11 > 0:02:14But it is a big risk, because if they're caught,
0:02:14 > 0:02:16not only will they end up out of pocket,
0:02:16 > 0:02:18but they could also be adding a criminal record
0:02:18 > 0:02:20to their list of credentials.
0:02:27 > 0:02:31There are over 25 million cars on Britain's roads,
0:02:32 > 0:02:35so it's no wonder that car crashes are pretty common.
0:02:36 > 0:02:39But even if the crashes themselves are genuine,
0:02:39 > 0:02:42the claims being made to insurers may not be.
0:02:47 > 0:02:52Simon Roylance has been working at insurance company LV for five years,
0:02:52 > 0:02:55and is always on the lookout for bogus claims.
0:02:57 > 0:03:01Our customer contacted us to advise that he'd been involved in an
0:03:01 > 0:03:05accident. He'd just reserved out of a parking bay at some shops.
0:03:05 > 0:03:07He was stationary at this point,
0:03:07 > 0:03:11giving way to another vehicle, when a van driver,
0:03:11 > 0:03:14who was also parked in one of the parking bays,
0:03:14 > 0:03:18didn't see his car and reversed into the passenger side rear.
0:03:19 > 0:03:23During this call, our customer told us that the vehicle had sustained
0:03:23 > 0:03:24quite significant damage.
0:04:10 > 0:04:14Wow. That is an awful lot for one collision,
0:04:14 > 0:04:16and it wasn't just the customer's Mercedes
0:04:16 > 0:04:18that had taken a hard knock.
0:04:19 > 0:04:23The customer said that he and his wife were in the vehicle at
0:04:23 > 0:04:25the time, and that they were both injured in the accident.
0:04:25 > 0:04:29They both had back pain, and he said that they'd also woken up
0:04:29 > 0:04:31the next morning with pain in the neck.
0:04:32 > 0:04:35So, all in all, a pretty bad 24 hours for this couple,
0:04:35 > 0:04:38but at least they were safe in the knowledge
0:04:38 > 0:04:39that their Mercedes was insured.
0:04:41 > 0:04:44As is the case with most motor insurance claims for damage,
0:04:44 > 0:04:48the vehicle involved is inspected before any money is paid out.
0:04:49 > 0:04:53The standard procedure in a case like this is for an engineer to take
0:04:53 > 0:04:54a look at the damage to the vehicle,
0:04:54 > 0:04:56and then assess whether it's repairable
0:04:56 > 0:04:58or whether the car needs to be written off.
0:05:00 > 0:05:04The engineer was provided with photographs of the damaged Mercedes,
0:05:04 > 0:05:06and was quick to come to a decision.
0:05:06 > 0:05:09In this case, the damage was so great that our engineer said that it
0:05:09 > 0:05:12was actually a write-off,
0:05:12 > 0:05:15with a value of around £13,500.
0:05:15 > 0:05:17So, a fair amount of money,
0:05:17 > 0:05:19but on closer inspection of the case details,
0:05:19 > 0:05:22something didn't seem quite right.
0:05:22 > 0:05:26It was at this point that our engineer alerted us to his concerns
0:05:26 > 0:05:28that the damage didn't seem to be consistent
0:05:28 > 0:05:31with the accident circumstances, and he suspected that
0:05:31 > 0:05:34the damage may have actually been exaggerated.
0:05:34 > 0:05:38The engineer then referred that into the Claims Crime Prevention Team
0:05:38 > 0:05:39for further investigation.
0:05:41 > 0:05:43They spoke to our customer again,
0:05:43 > 0:05:45just to go over the accident circumstances and make sure
0:05:45 > 0:05:47we were clear on what actually happened.
0:06:26 > 0:06:29The claimant was describing exactly the kind of accident that happens
0:06:29 > 0:06:32all too often in these types of parking areas,
0:06:32 > 0:06:35but the sheer volume of the damage to the Mercedes still
0:06:35 > 0:06:38didn't look like it'd been caused by a single impact
0:06:38 > 0:06:39with the Citroen van.
0:06:41 > 0:06:44LV decided to get forensic collision expert Brian Henderson involved,
0:06:44 > 0:06:49to look at the photographs and give his verdict on the case.
0:06:49 > 0:06:52What we expect is, if you look at the damage to one vehicle,
0:06:52 > 0:06:54you are expecting to see damage
0:06:54 > 0:06:58of a similar magnitude and at a similar height,
0:06:59 > 0:07:03to the damage on the other, because the two must match up.
0:07:05 > 0:07:08What we actually found was a surprise.
0:07:08 > 0:07:11There was considerable damage to the rear nearside,
0:07:11 > 0:07:15and indeed rear of the Mercedes ML.
0:07:15 > 0:07:17The damage extended all the way up to the roof,
0:07:17 > 0:07:19the glass was broken
0:07:19 > 0:07:22in the rear nearside window.
0:07:24 > 0:07:28And, indeed, there were considerable indentations in the roof,
0:07:28 > 0:07:32which was clearly outwith the height of the damage to the Citroen.
0:07:33 > 0:07:37But what was even more suspicious than the fact that the Citroen had
0:07:37 > 0:07:39hit the Mercedes higher than was physically possible,
0:07:39 > 0:07:43were the shapes of the marks on the bodywork.
0:07:43 > 0:07:45There were numerous areas where the vehicle
0:07:45 > 0:07:46had been struck with a hammer.
0:07:48 > 0:07:52I can only presume that that was to try and give the picture that
0:07:52 > 0:07:54perhaps there was more damage caused.
0:07:55 > 0:07:59It appeared that the claimant saw this as an opportunity to have his
0:07:59 > 0:08:03car written off, and had repeatedly hit it with a hammer
0:08:03 > 0:08:05to make sure it couldn't be repaired.
0:08:07 > 0:08:11It's not the most subtle
0:08:11 > 0:08:13of claims put forward
0:08:13 > 0:08:17that we've seen in 23-24 years that I've been doing this.
0:08:17 > 0:08:21It was rather simplistic in its approach, to be fair.
0:08:22 > 0:08:27Brian was 100% certain that the damage to the Mercedes couldn't have
0:08:27 > 0:08:31been caused by a single impact with the van, and reported his findings
0:08:31 > 0:08:33back to the insurance company.
0:08:33 > 0:08:37Shortly after we received the report from the forensic collision
0:08:37 > 0:08:41investigator, we received a phone call from our customer,
0:08:41 > 0:08:44asking what the progress had been on his claim.
0:08:45 > 0:08:49During that call we advised our customer that we didn't believe
0:08:49 > 0:08:53all of the damage to his vehicle was related to this accident,
0:08:53 > 0:08:55and that we wouldn't be settling his claim.
0:08:56 > 0:09:01Suspecting the claim was fraudulent, LV reported it to the police.
0:09:02 > 0:09:04After being interviewed by the police,
0:09:04 > 0:09:08our customer admitted an offence of fraud by false representation,
0:09:08 > 0:09:11and he was given a police caution for this.
0:09:11 > 0:09:14This means that he's now got a criminal record.
0:09:14 > 0:09:16He agreed to pay £1,000 compensation
0:09:16 > 0:09:19to LV and, in addition to all this,
0:09:19 > 0:09:23he'd also smashed up his £13,500 Mercedes.
0:09:23 > 0:09:27This man's attempt to go at it hammer and tongs had not only
0:09:27 > 0:09:29damaged his precious car,
0:09:29 > 0:09:32but left his bank balance in the red.
0:09:32 > 0:09:35It was another victory for the insurers,
0:09:35 > 0:09:38but one which left a bitter taste in their mouths.
0:09:38 > 0:09:41Whilst the majority of claims are genuine,
0:09:41 > 0:09:44false claims such as this are a problem.
0:09:44 > 0:09:46They drive up the premiums for everyone,
0:09:46 > 0:09:48and ultimately everybody foots the bill for that.
0:09:49 > 0:09:53The insurance industry and the police, though, are determined to
0:09:53 > 0:09:54tackle this kind of behaviour.
0:09:54 > 0:09:57And anyone caught committing this kind of fraud
0:09:57 > 0:10:01can expect prosecution, maybe even a criminal record.
0:10:07 > 0:10:11Now, when it comes to motor insurance claims, it's becoming
0:10:11 > 0:10:13increasingly common that the damage caused in a crash
0:10:13 > 0:10:17just doesn't match up with the description of the accident itself.
0:10:17 > 0:10:21As we've just seen, insurance companies are turning to forensic
0:10:21 > 0:10:24experts to examine the vehicles involved in suspicious claims,
0:10:24 > 0:10:28and determine if the given circumstances are correct
0:10:28 > 0:10:31or whether the claimant is trying to pull a fast one.
0:10:35 > 0:10:38Now, if, like me, you're wondering how these experts can tell
0:10:38 > 0:10:42the difference between a real crash and one that's been exaggerated,
0:10:42 > 0:10:46or even made up entirely, then now's your chance to find out.
0:10:47 > 0:10:51We are a forensic investigation company dealing with engineering
0:10:51 > 0:10:53motor vehicles, in particular.
0:10:53 > 0:10:56And we provide expert evidence on
0:10:56 > 0:11:00all manner of things - collisions, mechanical failures,
0:11:00 > 0:11:04fires - for the benefit of the court, ultimately.
0:11:04 > 0:11:08The experts at GBB all have mechanical engineering degrees
0:11:08 > 0:11:10or equivalent.
0:11:10 > 0:11:13Right the way up through to doctorates of engineering.
0:11:13 > 0:11:16We all have different specialisms.
0:11:16 > 0:11:20Mine happens to be relating to low speed and whiplash.
0:11:21 > 0:11:25Brian and his team had given the claimant's version of events,
0:11:25 > 0:11:28and were asked to match these up with the actual damage to the vehicles.
0:11:30 > 0:11:33Well, in any claim, we try to think that actually the matter
0:11:33 > 0:11:35is legitimate, for starters,
0:11:35 > 0:11:38and we will try and look for evidence to support the fact
0:11:38 > 0:11:39that it is legitimate.
0:11:39 > 0:11:41If we then cannot find that,
0:11:41 > 0:11:45we look for the evidence to try and support that it is fraudulent.
0:11:46 > 0:11:49With fraudulent claims becoming increasingly frequent,
0:11:49 > 0:11:54GBB set up their own unique crash testing programme,
0:11:54 > 0:11:57so they can better understand how the vehicles involved in a crash
0:11:57 > 0:11:58interact with each other.
0:12:00 > 0:12:05We are very, very good now at determining how damage was caused.
0:12:05 > 0:12:08So, in other words, at the moment that the other two vehicles come
0:12:08 > 0:12:11together, we are very, very good at being able to tell you
0:12:11 > 0:12:15precisely how they came together. The angle that they came together,
0:12:15 > 0:12:18what they were doing at the moments that they came together.
0:12:21 > 0:12:24Over the years, they've seen certain trends emerge when
0:12:24 > 0:12:26it comes to fraudulent claims.
0:12:27 > 0:12:30We initially used to get staged collisions.
0:12:30 > 0:12:33So, individual collisions with numerous people in them,
0:12:33 > 0:12:36so that actually it was a single high-value claim.
0:12:38 > 0:12:41What we find now with organised frauds is, particularly, is
0:12:41 > 0:12:43a series of lower value claims,
0:12:43 > 0:12:49perhaps in the hope that they're not investigated as rigorously as
0:12:49 > 0:12:51a higher value claim would be.
0:12:51 > 0:12:55With thorough testing of their own vehicles in accident reconstructions,
0:12:56 > 0:12:59they're able to catch out the fraudsters,
0:12:59 > 0:13:01no matter what their game is.
0:13:01 > 0:13:05I think the current trend towards slam-ons and so forth,
0:13:05 > 0:13:09and inducing collisions from others, is a very, very dangerous practice.
0:13:09 > 0:13:12I don't think for one minute any regard is given.
0:13:13 > 0:13:14Frankly, it's reckless.
0:13:15 > 0:13:19And it's only by good luck that somebody's not seriously injured
0:13:19 > 0:13:21in some of these cases.
0:13:28 > 0:13:31A victim's statement holds the key to a dubious claim.
0:13:43 > 0:13:47Every year, insurance companies receive around 130,000
0:13:47 > 0:13:49fraudulent claims.
0:13:49 > 0:13:51With figures steadily increasing,
0:13:51 > 0:13:54insurers are investing millions of pounds to identify
0:13:54 > 0:13:57these claims and catch the people behind them.
0:13:57 > 0:14:01However, when fraudulent claims are made against a state-run system,
0:14:01 > 0:14:06it means the cost of fraud is being funded by us - the taxpayers.
0:14:10 > 0:14:13The UK is home to 150 prisons,
0:14:13 > 0:14:16housing around 86,000 prisoners.
0:14:17 > 0:14:21But if you think this would be the last place to find a fraudulent
0:14:21 > 0:14:23claim, then you'd be sorely mistaken.
0:14:24 > 0:14:28Richard Vince is responsible for eight high security prisons
0:14:28 > 0:14:29in England and Wales.
0:14:30 > 0:14:33He knows just how common fraud in prisons can be,
0:14:33 > 0:14:36and the wider impact this can have.
0:14:36 > 0:14:41Fraudulent claims within prisons are a problem,
0:14:41 > 0:14:45in the same way that fraudulent claims made outside a prison is a problem.
0:14:45 > 0:14:49You know, that comes at a cost to society within the prison service.
0:14:51 > 0:14:56But this isn't the only reason why claims made in prisons need to be investigated.
0:14:56 > 0:14:59It's important to fight the claims from two perspectives, really.
0:14:59 > 0:15:02The first is, it's ongoing criminality from somebody who is
0:15:02 > 0:15:05already in prison for criminality.
0:15:05 > 0:15:08And secondly, it comes at a cost to the public purse,
0:15:08 > 0:15:11and that detracts
0:15:11 > 0:15:14valuable resource away from the ambitious reform programmes
0:15:14 > 0:15:16that we're under way at the moment,
0:15:16 > 0:15:18and our ability to reduce reoffending.
0:15:18 > 0:15:21And that has a very direct impact on public safety.
0:15:22 > 0:15:26Sarah McCracken deals with litigation for the high security prisons,
0:15:26 > 0:15:31and worked on a case at HMP Manchester back in 2012.
0:15:31 > 0:15:35The initial claim that came in was that the prisoner had slipped
0:15:35 > 0:15:37on a wet patch on the stairs.
0:15:37 > 0:15:40He'd fallen, hurting his lower back and his elbow.
0:15:40 > 0:15:43He was claiming of chronic back pain
0:15:43 > 0:15:45that was continued right up until the date
0:15:45 > 0:15:47that he put the claim in.
0:15:47 > 0:15:50Also, his injury to his elbow was quite serious as well,
0:15:50 > 0:15:52by all accounts.
0:15:52 > 0:15:56An unfortunate accident resulting in quite serious injuries,
0:15:56 > 0:16:01a claim that was likely to cost the prison service around £3,000.
0:16:01 > 0:16:03When the claim first came in,
0:16:03 > 0:16:05we treated it as an absolutely genuine claim,
0:16:05 > 0:16:07we had no reason to believe at that stage
0:16:07 > 0:16:10that there was anything untoward.
0:16:10 > 0:16:13The prison service began an investigation, which looked into
0:16:13 > 0:16:15the allegations made by the prisoner.
0:16:15 > 0:16:17As he had been injured in the fall,
0:16:17 > 0:16:20the first step was to have a look at his medical records.
0:16:20 > 0:16:23In this case, two medical experts were consulted.
0:16:23 > 0:16:26One was a GP, one was an orthopaedic consultant.
0:16:26 > 0:16:31The GP's report was extremely helpful towards the claimant's case.
0:16:31 > 0:16:37He did think that the injury was consistent with a slip on water,
0:16:37 > 0:16:41and the pain that he was still in was as a direct result of that accident.
0:16:41 > 0:16:45It looked like the prison service would be paying out for the claim.
0:16:45 > 0:16:48Until an interesting discrepancy popped up.
0:16:48 > 0:16:53The claimant had stated to the GP that he was unable to work.
0:16:53 > 0:16:56We knew from our own prison records that he was currently working
0:16:56 > 0:16:59and employed as a wing cleaner.
0:16:59 > 0:17:02The prisoner had claimed his injuries were so severe he'd been
0:17:02 > 0:17:04unable to work.
0:17:04 > 0:17:06Yet records show that he had continued with his prison job
0:17:06 > 0:17:09after the accident had taken place.
0:17:11 > 0:17:14And when the orthopaedic consultant's report came back,
0:17:14 > 0:17:16it cast a shadow over the case.
0:17:16 > 0:17:20He was able to interrogate the background medical evidence,
0:17:20 > 0:17:23and found that the claimant did have a quite extensive history
0:17:23 > 0:17:26of lower back pain and Sciatica.
0:17:26 > 0:17:29The consultant had spotted that the back pain had been a problem for
0:17:29 > 0:17:32some time before the accident.
0:17:32 > 0:17:35So, the prison service decided to investigate,
0:17:35 > 0:17:37and got their solicitors involved.
0:17:37 > 0:17:40There were a few things that caused us to pause and think further
0:17:40 > 0:17:42investigations were necessary.
0:17:42 > 0:17:44Firstly, the accident location.
0:17:44 > 0:17:47It appeared unlikely that anyone would have been in that location,
0:17:47 > 0:17:49and therefore that liquid could have been spilt
0:17:49 > 0:17:51since it was last cleaned.
0:17:52 > 0:17:56In addition, the claimant was in fact a cleaner within the prison.
0:17:56 > 0:17:58To some extent, therefore,
0:17:58 > 0:18:02it was his responsibility to ensure that the location was clean.
0:18:02 > 0:18:05It's also the case that he perhaps should have been better able
0:18:05 > 0:18:08to identify the hazard in this particular location,
0:18:08 > 0:18:10if it had been there.
0:18:12 > 0:18:15Henry and his team then turned to the prison staff to see if they
0:18:15 > 0:18:18could shed any light on the matter.
0:18:19 > 0:18:22We took two witness statements from two prison officers.
0:18:22 > 0:18:26The first officer was an officer who the claimant said he'd spoken to
0:18:26 > 0:18:28after the accident took place.
0:18:28 > 0:18:30That officer had no recollection of that conversation.
0:18:30 > 0:18:34The second prison officer we approached gave a helpful statement
0:18:34 > 0:18:36in relation to the accident location.
0:18:36 > 0:18:38Essentially backing up our version of events
0:18:38 > 0:18:41that this was not a location that was likely to have been
0:18:41 > 0:18:43accessed by anyone else overnight whilst prisoners
0:18:43 > 0:18:46were locked in their cells, or in the period since the location
0:18:46 > 0:18:47was last cleaned.
0:18:49 > 0:18:51So, let me see if I've got this straight.
0:18:51 > 0:18:55One, the prisoner was claiming he was unable to work due to his injuries,
0:18:55 > 0:18:59yet he continued to be employed by the prison service as a cleaner.
0:18:59 > 0:19:01Two, he had a history of back pain
0:19:01 > 0:19:05that started long before the accident had occurred.
0:19:05 > 0:19:07And three, on the day of the accident,
0:19:07 > 0:19:11the prisoner was the first person to use the staircase,
0:19:11 > 0:19:14making it extremely unlikely there was even any liquid
0:19:14 > 0:19:17for him to slip on.
0:19:17 > 0:19:18Looking at all the evidence,
0:19:18 > 0:19:22there appeared to be very little to support the claimant's case.
0:19:22 > 0:19:25And therefore, we thought we were in a very strong position to take
0:19:25 > 0:19:27this case to trial.
0:19:27 > 0:19:2913 months after the claim had been made,
0:19:29 > 0:19:33a hearing took place at Manchester Civil Justice Centre.
0:19:33 > 0:19:37It's fair to say that the claimant was not strong in his evidence
0:19:37 > 0:19:40at trial. He struggled as to whether he'd fallen down 12 steps,
0:19:40 > 0:19:42or two steps.
0:19:42 > 0:19:45He was also in difficulties when presented with his
0:19:45 > 0:19:47medical and employment history,
0:19:47 > 0:19:51to such an extent that his own barrister later described him
0:19:51 > 0:19:53as a poor historian.
0:19:53 > 0:19:55The claim was dismissed,
0:19:55 > 0:19:58and the prisoner was ordered to pay £9,000 in legal costs
0:19:58 > 0:20:00to the Prison Service.
0:20:01 > 0:20:03In this case, we thought it was the right result,
0:20:03 > 0:20:06that it was entirely in line with the evidence the judge had seen,
0:20:06 > 0:20:10and that he took the right decision in dismissing the claim and finding
0:20:10 > 0:20:12no fault on the part of the Prison Service.
0:20:13 > 0:20:16So, a great result all-round.
0:20:16 > 0:20:19And if the legal costs weren't a big enough price to pay,
0:20:19 > 0:20:24three years after his release, this con artist really got his comeuppance.
0:20:24 > 0:20:27Despite claiming he couldn't work after the accident,
0:20:27 > 0:20:30he was later employed as a builder.
0:20:30 > 0:20:35He was climbing a ladder when he was the victim of a genuine accident.
0:20:35 > 0:20:38The ladder slipped, causing him to crash to the ground.
0:20:38 > 0:20:41He was hurt but not badly.
0:20:41 > 0:20:44Now, I'm not sure if you believe in karma, but,
0:20:44 > 0:20:46after watching this,
0:20:46 > 0:20:48I think I might just be convinced.
0:20:53 > 0:20:56All right, let's talk rear-end shunts.
0:20:56 > 0:20:59Which, if you're wondering, isn't an elaborate dance move.
0:20:59 > 0:21:03No, that's when one car hits another from behind.
0:21:03 > 0:21:06Now, when this type of accident occurs, it's almost always
0:21:06 > 0:21:08presumed the driver who crashed into the car in front
0:21:08 > 0:21:12is at fault for not driving at a safe stopping distance.
0:21:12 > 0:21:16But some fraudsters see these collisions as the perfect opportunity to
0:21:16 > 0:21:18pull a fast one on insurers.
0:21:21 > 0:21:25Insurance companies pay out around £28.6 million
0:21:25 > 0:21:27in motor claims every day,
0:21:27 > 0:21:30many of which are accidents involving rear-end collisions.
0:21:32 > 0:21:34Whilst the majority of these are innocent mistakes,
0:21:34 > 0:21:36some are far from accidental.
0:21:38 > 0:21:42Allan Peak is a fraud manager at Markerstudy Insurance.
0:21:42 > 0:21:46He received a call from a customer reporting a rather suspicious crash.
0:21:48 > 0:21:53Our policyholder's version of events was that he was stationary
0:21:53 > 0:21:56at traffic lights behind this vehicle.
0:21:56 > 0:22:00The third party vehicle commenced on to the roundabout.
0:22:00 > 0:22:02Our policyholder followed.
0:22:02 > 0:22:05And then, suddenly, the third party brakes quite heavily.
0:22:05 > 0:22:08The policyholder also brakes.
0:22:08 > 0:22:11He was unable to stop in time, and he collided with the rear
0:22:11 > 0:22:14of the claimant's vehicle at around 10mph.
0:22:16 > 0:22:20After the collision, the policyholder spoke with
0:22:20 > 0:22:24the third party, asked directly, "Why did you stop?"
0:22:24 > 0:22:27There was no reason for them to stop quite so suddenly.
0:22:27 > 0:22:30And the third-party passenger suggested that there was some
0:22:30 > 0:22:34sat nav-related reason for that stop.
0:22:36 > 0:22:38Now, I might be out of the loop,
0:22:38 > 0:22:42but since when did a Sat Nav order a driver to make an emergency stop?
0:22:44 > 0:22:46The policyholder was suspicious,
0:22:46 > 0:22:48and immediately called his insurance company.
0:23:19 > 0:23:23They then received a claim from the couple in the car in front.
0:23:23 > 0:23:27But when asked for their account of the accident, the circumstances
0:23:27 > 0:23:30they gave were completely different.
0:23:30 > 0:23:34The third-party's version of events was that they were simply stationary
0:23:34 > 0:23:36at the traffic lights for four or five seconds,
0:23:36 > 0:23:39when our policyholder collided with the rear of the vehicle.
0:23:41 > 0:23:45Hang on, I thought the accident happened on the roundabout,
0:23:45 > 0:23:46not at the traffic lights?
0:23:47 > 0:23:48And as for the claim itself,
0:23:48 > 0:23:51it was far greater than the insurers had expected.
0:23:54 > 0:23:57The claimant's version suggested a fairly significant impact
0:23:57 > 0:24:00was sufficient to write the vehicle off
0:24:00 > 0:24:03and cause personal injury to both occupants of the vehicle.
0:24:04 > 0:24:08The insurers then asked for evidence to support the personal injury
0:24:08 > 0:24:12claims, and subsequently received a report from an independent GP.
0:24:13 > 0:24:17In the report, the claimant stated on a scale of one to ten,
0:24:17 > 0:24:19her pain had been an eight.
0:24:19 > 0:24:23She said that for eight weeks, sleep was disturbed to
0:24:23 > 0:24:25the extent she had take sleeping pills.
0:24:25 > 0:24:28She claimed that she was very anxious to the extent that she was
0:24:28 > 0:24:30no longer able to drive a vehicle.
0:24:30 > 0:24:34And she was unable to attend the scene of the accident again
0:24:34 > 0:24:36because it gave her nightmares.
0:24:36 > 0:24:40Well, that is a pretty big statement to make for someone whose car was
0:24:40 > 0:24:44crashed into - and remember, at a low speed.
0:24:44 > 0:24:47Overall, we estimated the value of the claims for injury
0:24:47 > 0:24:50to be between £2,000 and £3,000 each.
0:24:50 > 0:24:53So, along with the claims for vehicle damage and travel expenses,
0:24:53 > 0:24:57we were looking at a claim that included third-party solicitor costs
0:24:57 > 0:25:01of up to around £22,000 in total for both claimants.
0:25:04 > 0:25:08Markerstudy then involved their own lawyers, DWF Solicitors,
0:25:08 > 0:25:12and asked them to investigate the allegations of fraud.
0:25:12 > 0:25:15From the outset of this, it's quite clear there's a discrepancy
0:25:15 > 0:25:18in the two accounts that have been provided.
0:25:18 > 0:25:21Ordinarily, we would assume that any person who drives into the rear
0:25:21 > 0:25:25of someone else would naturally be at fault for the accident.
0:25:25 > 0:25:27That's generally an accepted principle.
0:25:27 > 0:25:30The quirk to this case is that the defendant's suggesting that
0:25:30 > 0:25:33the claimant has stopped deliberately. So, actually,
0:25:33 > 0:25:35the defendant is alleging that the claimant driver is at fault for
0:25:35 > 0:25:38the collision. Obviously, that's not what the claimant is saying.
0:25:38 > 0:25:40The claimant is saying "No, you've hit me in the rear,
0:25:40 > 0:25:42"therefore, you should be held at fault."
0:25:42 > 0:25:45To get to the bottom of exactly who was at fault,
0:25:45 > 0:25:48the solicitors turned to a witness who had been following both vehicles
0:25:48 > 0:25:50at the time of the accident.
0:25:50 > 0:25:54The independent witness was supportive of the defendant's
0:25:54 > 0:25:58version of events. He had the fortunate view of being in a lorry,
0:25:58 > 0:26:01so he could see in front of both vehicles,
0:26:01 > 0:26:03and was able to say quite clearly that the claimant
0:26:03 > 0:26:05had stopped without apparent reason,
0:26:05 > 0:26:08and not only that, stopped very abruptly,
0:26:08 > 0:26:11which again supported the broad principle of our defendant
0:26:11 > 0:26:13saying that he had been deliberately induced.
0:26:15 > 0:26:18DWF had now gathered enough evidence
0:26:18 > 0:26:22to prove that the couple in front were at fault,
0:26:22 > 0:26:24and decided to take the case to court.
0:26:24 > 0:26:28But on the day of the trial, the claimant failed to turn up.
0:26:28 > 0:26:32The big inference we were able to draw from their lack of attendance
0:26:32 > 0:26:34was that we'd hit the nail on the head,
0:26:34 > 0:26:36and the allegations obviously had merit and weight.
0:26:36 > 0:26:39The claim ended up being dismissed at hearing.
0:26:39 > 0:26:42The judge granted the defendants nearly £7,000
0:26:42 > 0:26:44in respect of their own costs,
0:26:44 > 0:26:47which were incurred during the defence of the claim.
0:26:48 > 0:26:50A superb result all round.
0:26:50 > 0:26:54In terms of the overall outcome of the case, we were very, very pleased
0:26:54 > 0:26:56that Markerstudy avoided having to make any payments.
0:26:56 > 0:27:00We were also confident that had a judge considered the case
0:27:00 > 0:27:02and listened to the claimant's evidence,
0:27:02 > 0:27:05then a judge would have found for us and established
0:27:05 > 0:27:07that the claim had been induced.
0:27:07 > 0:27:11Unfortunately, cases like this are becoming more and more common,
0:27:11 > 0:27:15and it's the innocent victims who end up suffering the most.
0:27:15 > 0:27:19It's vital for us to come combat this type of fraud and to identify
0:27:19 > 0:27:22as many of these cases as we possibly can, and to subsequently defend them,
0:27:22 > 0:27:26for a number of reasons. Most importantly of all, actually,
0:27:26 > 0:27:30these type of collisions are putting innocent motorists at risk.
0:27:31 > 0:27:32This was a minor impact,
0:27:32 > 0:27:35but how much would it take for one of these to go wrong and for
0:27:35 > 0:27:38serious damage and injury to be caused to an innocent motorist?
0:27:44 > 0:27:45Still to come...
0:27:45 > 0:27:50A conniving couple are caught out when they make a comedy of errors.
0:27:50 > 0:27:53She showed little or no emotion in regard to the fact that
0:27:53 > 0:27:56he'd just been held at knife-point and had numerous items of
0:27:56 > 0:27:59significant value stolen from her home.
0:28:04 > 0:28:06We are a nation of pet lovers,
0:28:06 > 0:28:10with around 20% of us insuring our furry friends.
0:28:10 > 0:28:13And it's no wonder why, as recent rises in vets' fees
0:28:13 > 0:28:16means insurance companies are now paying out
0:28:16 > 0:28:21£1.8 million in claims every single day.
0:28:23 > 0:28:26Agria is one of the world's leading pet insurers,
0:28:26 > 0:28:29and is well aware of the problem of insurance fraud.
0:28:29 > 0:28:31So, before getting the cheque-book out,
0:28:31 > 0:28:34they check and validate every claim that comes in.
0:28:37 > 0:28:39Simon Wheeler, Agria's managing director,
0:28:39 > 0:28:41tells us about a tricky case
0:28:41 > 0:28:43they dealt with that concerns a poorly pup.
0:28:45 > 0:28:48We received a call from our policyholder, who advised us
0:28:48 > 0:28:50that his new Border terrier puppy
0:28:50 > 0:28:54had had an accident in the evening, had broken its leg,
0:28:54 > 0:28:57and they'd had to rush it to the out of hours emergency vets.
0:30:03 > 0:30:05It looked like a clear-cut case.
0:30:05 > 0:30:08The accident had happened before the policy had started,
0:30:08 > 0:30:11so, unfortunately, the customer wasn't covered.
0:30:11 > 0:30:15We then had yet another call from the owner, two hours later,
0:30:15 > 0:30:17and he'd revised some of his facts.
0:30:17 > 0:30:19He'd made a phone call to the vet,
0:30:19 > 0:30:22and he'd made a phone call to his father, and his father had
0:30:22 > 0:30:25categorically advised him that the puppy had injured
0:30:25 > 0:30:28itself at ten o'clock and, so, no,
0:30:28 > 0:30:30that was well and truly after the policy had been set up.
0:30:42 > 0:30:46So, having initially claimed that the puppy broke its leg around 9pm,
0:30:46 > 0:30:50the policyholder had now changed his story to say that it had happened
0:30:50 > 0:30:55around 10pm, conveniently, after the policy had been put in place,
0:30:55 > 0:30:58and when the insurance had become valid.
0:30:58 > 0:31:02So, the next we heard from the policyholder was when the claim came through.
0:31:02 > 0:31:04A claim for £1,100.
0:31:04 > 0:31:08On the claim form were all the latest set of details.
0:31:09 > 0:31:12The next step in the process was that we contacted the breeder,
0:31:12 > 0:31:15just to verify what had been said in the claim form.
0:31:15 > 0:31:20And the details they gave us exactly matched the details in the claim form.
0:31:20 > 0:31:22They were like a script, down to the letter.
0:31:26 > 0:31:30Could the owner and the breeder have spoken to align their stories?
0:31:30 > 0:31:34Or was the insurance company barking up the wrong tree?
0:31:34 > 0:31:38Agria decided to make contact with the vet to see if they had any
0:31:38 > 0:31:41record of the timings for the evening in question.
0:31:41 > 0:31:43If the owner was telling the truth,
0:31:43 > 0:31:48the vet's record would show the consultation happening after 10pm.
0:31:49 > 0:31:51The sequence of events would be,
0:31:51 > 0:31:53animal was injured at about ten o'clock,
0:31:53 > 0:31:56the owner would try to find an out-of-hours vet,
0:31:56 > 0:32:00would go to the out of hours, the vet would see the animal,
0:32:00 > 0:32:02and then probably write up the notes, the consult notes,
0:32:02 > 0:32:04after treatment had been given.
0:32:05 > 0:32:08The note was written up at 10.23pm,
0:32:08 > 0:32:12so effectively tying in, possibly.
0:32:12 > 0:32:16It was after the insurance had been set up but at a very, very short
0:32:16 > 0:32:19timescale, so we needed to investigate further.
0:32:19 > 0:32:23The insurers weren't going to let sleeping dogs lie,
0:32:23 > 0:32:27and still needed proof of the time the owner had called the vets.
0:32:27 > 0:32:29There was only one way of finding out.
0:32:54 > 0:32:57Although we asked for phone records for the whole evening,
0:32:57 > 0:33:00what the policyholder sent through
0:33:00 > 0:33:02was a very precise, cropped phone record
0:33:02 > 0:33:06that started at 10.01 and went onwards.
0:33:06 > 0:33:08That period between nine and ten,
0:33:08 > 0:33:13the potential contentious period, was completely missing.
0:33:13 > 0:33:17And when we pushed the policyholder for the rest of the telephone records,
0:33:17 > 0:33:20there were lots of excuses made why we couldn't have those.
0:34:30 > 0:34:34Those phone records between nine and ten would have given us sufficient
0:34:34 > 0:34:36evidence to say, "Yes, this is, of course, a valid claim."
0:34:36 > 0:34:39In the absence of anything,
0:34:39 > 0:34:42the doubt and suspicion very much is that the incident occurred
0:34:42 > 0:34:43at nine o'clock,
0:34:43 > 0:34:46and there were records on that phone bill that didn't,
0:34:46 > 0:34:49didn't tie in with the revised story.
0:34:51 > 0:34:54So, the final contact with the customer was that we e-mailed
0:34:54 > 0:34:59them and asked for the full telephone records for that day,
0:34:59 > 0:35:03and despite that e-mail, despite the conversation we'd had with them,
0:35:03 > 0:35:06those records were never forthcoming,
0:35:06 > 0:35:08so complete radio silence from the policyholder.
0:35:08 > 0:35:11There is sufficient doubt for us to reject the claim.
0:35:11 > 0:35:14The policyholder hasn't come forth with sufficient evidence to prove
0:35:14 > 0:35:18that the changed story is actually the factual story,
0:35:18 > 0:35:21so we rejected the claim.
0:35:21 > 0:35:24Considering how easy it would have been to validate the claim had
0:35:24 > 0:35:27the policyholder provided the earlier phone records,
0:35:27 > 0:35:32their refusal to do so strongly suggested that this was indeed
0:35:32 > 0:35:34a spurious claim.
0:35:34 > 0:35:37Fraud isn't acceptable in any guise.
0:35:37 > 0:35:40In this instance, it was a clumsy attempt to defraud us of money,
0:35:40 > 0:35:44where the breeder made mistakes, where the new owner made mistakes.
0:35:44 > 0:35:48Our claims assessors are hugely skilled at identifying fraud
0:35:48 > 0:35:50in a much more sophisticated way.
0:35:50 > 0:35:53Most claims come in, nothing changes,
0:35:53 > 0:35:55the facts are clear and we pay the claims.
0:35:55 > 0:35:58In instances like this, where times are changing -
0:35:58 > 0:36:01huge indicators of fraud and then when they can't be backed up with
0:36:01 > 0:36:04evidence, no, absolutely, they'll be outed every time.
0:36:10 > 0:36:13Unfortunately, there are fraudsters out there who will sink
0:36:13 > 0:36:17to diabolical depths to get their hands on a pay-out.
0:36:17 > 0:36:20Even if it means concocting elaborate accounts
0:36:20 > 0:36:22of traumatic events that never even happened.
0:36:22 > 0:36:25But many of these criminals often make careless
0:36:25 > 0:36:28mistakes, and when they're caught out,
0:36:28 > 0:36:30the consequences of their actions
0:36:30 > 0:36:33can be far greater than they ever imagined.
0:36:37 > 0:36:40Tom Wilson is a Counter Fraud Manager at AXA,
0:36:40 > 0:36:43and recently dealt with a rather distressing case.
0:36:45 > 0:36:49So, on this occasion, we had a claim coming from Paul and Zoe Sizurk.
0:36:49 > 0:36:53It was a household claim, where they claimed that they'd been held
0:36:53 > 0:36:55at knife-point in their home,
0:36:55 > 0:37:00whilst balaclava-clad thieves stole £17,000 worth of jewellery,
0:37:00 > 0:37:02cash and a number of other items.
0:37:02 > 0:37:08To be held at knife-point in your own home must be a pretty harrowing ordeal.
0:37:08 > 0:37:10Everything, quick! Hurry up!
0:37:10 > 0:37:14So it was important that they dealt with the Sizurks' claim as
0:37:14 > 0:37:16quickly and efficiently as possible.
0:37:17 > 0:37:20From the outset, with any claim that's reported to us,
0:37:20 > 0:37:21we treat them as genuine
0:37:21 > 0:37:23unless there's reason to suggest otherwise.
0:37:23 > 0:37:25In this particular instance,
0:37:25 > 0:37:28the concern that was initially raised was when we spoke to Zoe
0:37:28 > 0:37:30on the phone when she reported the incident.
0:37:32 > 0:37:36She showed little or no emotion in regards to the fact that she'd just
0:37:36 > 0:37:39been held at knife-point and had numerous items of significant value
0:37:39 > 0:37:40stolen from her home.
0:38:34 > 0:38:39Zoe was obviously concerned about the missing cash and jewellery,
0:38:39 > 0:38:42but didn't paint a picture of a woman who'd just been robbed
0:38:42 > 0:38:43at knife-point.
0:38:43 > 0:38:46With claims of this nature, it's our standard practice
0:38:46 > 0:38:49to appoint one of our partner loss adjusters,
0:38:49 > 0:38:52who would attend upon the premises of the customer
0:38:52 > 0:38:55to run through the details of what happened, what was stolen, etc.
0:38:58 > 0:39:02When our adjuster met with Zoe, she asked her what happened.
0:39:02 > 0:39:05At no point did she mention that her and her husband had been held at
0:39:05 > 0:39:09knife-point in their home whilst these thieves ransacked the house
0:39:09 > 0:39:11and stole this jewellery.
0:39:11 > 0:39:13Something really odd, given the experience
0:39:13 > 0:39:15that they alleged to have been through.
0:39:15 > 0:39:19You would've thought that it's the first thing that they'd mention.
0:39:19 > 0:39:23Already, the circumstances seem a little suspicious,
0:39:23 > 0:39:27but AXA were prepared to give the Sizurks the benefit of the doubt.
0:39:27 > 0:39:30It was only when Zoe listed the items that had been stolen
0:39:30 > 0:39:35to the loss adjuster that the true nature of the claim became apparent.
0:39:36 > 0:39:39More alarming was that during the course of the meeting,
0:39:39 > 0:39:42some of the items she claimed that had been stolen,
0:39:42 > 0:39:43she was actually wearing.
0:39:48 > 0:39:51Hold on - you'd think if someone was claiming for stolen jewellery,
0:39:51 > 0:39:54surely they wouldn't wear it during an interview
0:39:54 > 0:39:57with the person handling the claim.
0:39:57 > 0:40:01So, the loss adjuster reported back, and investigators decided to
0:40:01 > 0:40:05interview Zoe's husband to try and suss out whether the claim
0:40:05 > 0:40:08could in any way be genuine.
0:40:08 > 0:40:12Our adjuster contacted us to advise us of the concerns.
0:40:12 > 0:40:15We arranged to meet with Paul, Zoe's husband,
0:40:15 > 0:40:18to get his account as well, and during that meeting,
0:40:18 > 0:40:20Zoe was present and, again,
0:40:20 > 0:40:23Paul didn't mention the robbery at all and it wasn't until Zoe
0:40:23 > 0:40:25prompted him that he mentioned it.
0:40:26 > 0:40:29Although the couple's story matched up,
0:40:29 > 0:40:33the insurers still didn't know if the robbery had actually taken place,
0:40:33 > 0:40:36and, even if it had, £17,000 worth of goods
0:40:36 > 0:40:39was a lot to be claiming for.
0:40:39 > 0:40:41With incidents of this nature,
0:40:41 > 0:40:43we would always ask for proof of purchase.
0:40:43 > 0:40:46We need to ensure that the items being claimed
0:40:46 > 0:40:48were actually purchased in the first instance
0:40:48 > 0:40:50and were owned by the customer.
0:40:50 > 0:40:53On this occasion, a number of the items she claimed to have been
0:40:53 > 0:40:56stolen, they just couldn't provide proof of purchase for.
0:40:59 > 0:41:02So, following the concerns that we identified,
0:41:02 > 0:41:03and the clear discrepancies,
0:41:03 > 0:41:08we put these to Zoe and Paul and they weren't able to provide
0:41:08 > 0:41:10a reasonable explanation as to these discrepancies,
0:41:10 > 0:41:14and that led to us making a decision to not pay the claim.
0:41:14 > 0:41:16AXA contacted the police,
0:41:16 > 0:41:19who later arrested the couple at their home.
0:41:19 > 0:41:21Yet again, Zoe was wearing some of the pieces
0:41:21 > 0:41:25of jewellery she claimed had been taken in the robbery.
0:41:25 > 0:41:28Following the arrest of Paul and Zoe, the police charged them
0:41:28 > 0:41:31with fraud by false representation.
0:41:31 > 0:41:35Both pled guilty to the charge and a hearing date for their sentencing was set.
0:41:35 > 0:41:39But when that date arrived - yup, you guessed it -
0:41:39 > 0:41:41Paul and Zoe didn't turn up to court.
0:41:43 > 0:41:45They were arrested at Manchester Airport,
0:41:45 > 0:41:47where they were trying to flee the country,
0:41:47 > 0:41:50but there was no escaping the long arm of the law.
0:41:50 > 0:41:53On that date, they attended the sentencing hearing
0:41:53 > 0:41:56and were both handed down 16 months behind bars.
0:42:00 > 0:42:03The fact that they didn't attend the sentencing hearing that was
0:42:03 > 0:42:06originally set, and were then later arrested at the airport,
0:42:06 > 0:42:09suggested they had no intention of attending the hearing,
0:42:09 > 0:42:12and my view is that that probably contributed to the
0:42:12 > 0:42:16very serious nature of the sentence they did eventually receive.
0:42:17 > 0:42:22Ultimately, this couple discovered that crime really doesn't pay.
0:42:22 > 0:42:25The outcome of the custodial sentence - brilliant result.
0:42:25 > 0:42:28It goes to show that the courts are prepared to hand out some
0:42:28 > 0:42:31fairly hard sentences to would-be fraudsters,
0:42:31 > 0:42:33and it should act as a deterrent for anybody considering
0:42:33 > 0:42:35submitting a fraudulent claim.
0:42:41 > 0:42:43Whether it's exaggerating real injuries,
0:42:43 > 0:42:46totally making up a story for a dodgy claim
0:42:46 > 0:42:49or masterminding insurance fraud on an industrial scale,
0:42:49 > 0:42:53the law is coming down hard on the people who think they can
0:42:53 > 0:42:56make a quick buck with their insurance scams and cons.
0:42:56 > 0:42:59But the fraudsters need to think again, as more of them than
0:42:59 > 0:43:03ever before are being caught in the act and claimed and shamed.