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Insurance fraud in the UK has hit epidemic levels. | 0:00:06 | 0:00:09 | |
It's costing us more than £1.3 billion every year. | 0:00:09 | 0:00:14 | |
That's almost £3.6 million every day. | 0:00:14 | 0:00:17 | |
Deliberate crashes, bogus personal injuries, | 0:00:19 | 0:00:22 | |
even phantom pets. | 0:00:22 | 0:00:24 | |
The fraudsters are risking more and more to make a quick killing, | 0:00:25 | 0:00:29 | |
and every year it's adding around £50 to your insurance bill. | 0:00:29 | 0:00:33 | |
But insurers are fighting back, | 0:00:33 | 0:00:35 | |
exposing under just 15 fake claims every hour. | 0:00:35 | 0:00:39 | |
Armed with covert surveillance systems... | 0:00:39 | 0:00:41 | |
That's the subject out the vehicle. | 0:00:41 | 0:00:44 | |
..sophisticated data analysis techniques... | 0:00:44 | 0:00:47 | |
POLICE! | 0:00:47 | 0:00:48 | |
..and a number of highly skilled police units... | 0:00:48 | 0:00:51 | |
Police, don't move! Stay where you are! | 0:00:51 | 0:00:53 | |
..they're catching the criminals red-handed. | 0:00:53 | 0:00:55 | |
Just don't lie to us. | 0:00:55 | 0:00:56 | |
All those conmen, scammers and cheats on the fiddle | 0:00:58 | 0:01:01 | |
are now caught in the act and claimed and shamed. | 0:01:01 | 0:01:04 | |
Suspicious car damage gives forensic investigators cause for concern. | 0:01:12 | 0:01:16 | |
Our engineer alerted us to his concerns that the damage | 0:01:17 | 0:01:20 | |
didn't seem to be consistent with the accident circumstances, | 0:01:20 | 0:01:24 | |
and he suspected that the damage may have actually been exaggerated. | 0:01:24 | 0:01:27 | |
A severe case of amnesia catches out a convicted criminal. | 0:01:28 | 0:01:33 | |
He struggled as to whether he'd fallen down 12 steps or two steps. | 0:01:33 | 0:01:38 | |
He was also in difficulties when presented with | 0:01:38 | 0:01:40 | |
his medical and employment history. | 0:01:40 | 0:01:43 | |
..and a puppy owner's failure to get his facts straight | 0:01:43 | 0:01:47 | |
rings alarm bells. | 0:01:47 | 0:01:49 | |
His father had categorically advised him that the puppy | 0:01:49 | 0:01:52 | |
had injured itself at ten o'clock - | 0:01:52 | 0:01:54 | |
that was well and truly after the policy had been set up. | 0:01:54 | 0:01:57 | |
Fraudsters will often exaggerate the details of an accident, or the | 0:02:02 | 0:02:06 | |
damage caused to their vehicle, in order to try and get more money out | 0:02:06 | 0:02:09 | |
of their insurance company. | 0:02:09 | 0:02:11 | |
But it is a big risk, because if they're caught, | 0:02:11 | 0:02:14 | |
not only will they end up out of pocket, | 0:02:14 | 0:02:16 | |
but they could also be adding a criminal record | 0:02:16 | 0:02:18 | |
to their list of credentials. | 0:02:18 | 0:02:20 | |
There are over 25 million cars on Britain's roads, | 0:02:27 | 0:02:31 | |
so it's no wonder that car crashes are pretty common. | 0:02:32 | 0:02:35 | |
But even if the crashes themselves are genuine, | 0:02:36 | 0:02:39 | |
the claims being made to insurers may not be. | 0:02:39 | 0:02:42 | |
Simon Roylance has been working at insurance company LV for five years, | 0:02:47 | 0:02:52 | |
and is always on the lookout for bogus claims. | 0:02:52 | 0:02:55 | |
Our customer contacted us to advise that he'd been involved in an | 0:02:57 | 0:03:01 | |
accident. He'd just reserved out of a parking bay at some shops. | 0:03:01 | 0:03:05 | |
He was stationary at this point, | 0:03:05 | 0:03:07 | |
giving way to another vehicle, when a van driver, | 0:03:07 | 0:03:11 | |
who was also parked in one of the parking bays, | 0:03:11 | 0:03:14 | |
didn't see his car and reversed into the passenger side rear. | 0:03:14 | 0:03:18 | |
During this call, our customer told us that the vehicle had sustained | 0:03:19 | 0:03:23 | |
quite significant damage. | 0:03:23 | 0:03:24 | |
Wow. That is an awful lot for one collision, | 0:04:10 | 0:04:14 | |
and it wasn't just the customer's Mercedes | 0:04:14 | 0:04:16 | |
that had taken a hard knock. | 0:04:16 | 0:04:18 | |
The customer said that he and his wife were in the vehicle at | 0:04:19 | 0:04:23 | |
the time, and that they were both injured in the accident. | 0:04:23 | 0:04:25 | |
They both had back pain, and he said that they'd also woken up | 0:04:25 | 0:04:29 | |
the next morning with pain in the neck. | 0:04:29 | 0:04:31 | |
So, all in all, a pretty bad 24 hours for this couple, | 0:04:32 | 0:04:35 | |
but at least they were safe in the knowledge | 0:04:35 | 0:04:38 | |
that their Mercedes was insured. | 0:04:38 | 0:04:39 | |
As is the case with most motor insurance claims for damage, | 0:04:41 | 0:04:44 | |
the vehicle involved is inspected before any money is paid out. | 0:04:44 | 0:04:48 | |
The standard procedure in a case like this is for an engineer to take | 0:04:49 | 0:04:53 | |
a look at the damage to the vehicle, | 0:04:53 | 0:04:54 | |
and then assess whether it's repairable | 0:04:54 | 0:04:56 | |
or whether the car needs to be written off. | 0:04:56 | 0:04:58 | |
The engineer was provided with photographs of the damaged Mercedes, | 0:05:00 | 0:05:04 | |
and was quick to come to a decision. | 0:05:04 | 0:05:06 | |
In this case, the damage was so great that our engineer said that it | 0:05:06 | 0:05:09 | |
was actually a write-off, | 0:05:09 | 0:05:12 | |
with a value of around £13,500. | 0:05:12 | 0:05:15 | |
So, a fair amount of money, | 0:05:15 | 0:05:17 | |
but on closer inspection of the case details, | 0:05:17 | 0:05:19 | |
something didn't seem quite right. | 0:05:19 | 0:05:22 | |
It was at this point that our engineer alerted us to his concerns | 0:05:22 | 0:05:26 | |
that the damage didn't seem to be consistent | 0:05:26 | 0:05:28 | |
with the accident circumstances, and he suspected that | 0:05:28 | 0:05:31 | |
the damage may have actually been exaggerated. | 0:05:31 | 0:05:34 | |
The engineer then referred that into the Claims Crime Prevention Team | 0:05:34 | 0:05:38 | |
for further investigation. | 0:05:38 | 0:05:39 | |
They spoke to our customer again, | 0:05:41 | 0:05:43 | |
just to go over the accident circumstances and make sure | 0:05:43 | 0:05:45 | |
we were clear on what actually happened. | 0:05:45 | 0:05:47 | |
The claimant was describing exactly the kind of accident that happens | 0:06:26 | 0:06:29 | |
all too often in these types of parking areas, | 0:06:29 | 0:06:32 | |
but the sheer volume of the damage to the Mercedes still | 0:06:32 | 0:06:35 | |
didn't look like it'd been caused by a single impact | 0:06:35 | 0:06:38 | |
with the Citroen van. | 0:06:38 | 0:06:39 | |
LV decided to get forensic collision expert Brian Henderson involved, | 0:06:41 | 0:06:44 | |
to look at the photographs and give his verdict on the case. | 0:06:44 | 0:06:49 | |
What we expect is, if you look at the damage to one vehicle, | 0:06:49 | 0:06:52 | |
you are expecting to see damage | 0:06:52 | 0:06:54 | |
of a similar magnitude and at a similar height, | 0:06:54 | 0:06:58 | |
to the damage on the other, because the two must match up. | 0:06:59 | 0:07:03 | |
What we actually found was a surprise. | 0:07:05 | 0:07:08 | |
There was considerable damage to the rear nearside, | 0:07:08 | 0:07:11 | |
and indeed rear of the Mercedes ML. | 0:07:11 | 0:07:15 | |
The damage extended all the way up to the roof, | 0:07:15 | 0:07:17 | |
the glass was broken | 0:07:17 | 0:07:19 | |
in the rear nearside window. | 0:07:19 | 0:07:22 | |
And, indeed, there were considerable indentations in the roof, | 0:07:24 | 0:07:28 | |
which was clearly outwith the height of the damage to the Citroen. | 0:07:28 | 0:07:32 | |
But what was even more suspicious than the fact that the Citroen had | 0:07:33 | 0:07:37 | |
hit the Mercedes higher than was physically possible, | 0:07:37 | 0:07:39 | |
were the shapes of the marks on the bodywork. | 0:07:39 | 0:07:43 | |
There were numerous areas where the vehicle | 0:07:43 | 0:07:45 | |
had been struck with a hammer. | 0:07:45 | 0:07:46 | |
I can only presume that that was to try and give the picture that | 0:07:48 | 0:07:52 | |
perhaps there was more damage caused. | 0:07:52 | 0:07:54 | |
It appeared that the claimant saw this as an opportunity to have his | 0:07:55 | 0:07:59 | |
car written off, and had repeatedly hit it with a hammer | 0:07:59 | 0:08:03 | |
to make sure it couldn't be repaired. | 0:08:03 | 0:08:05 | |
It's not the most subtle | 0:08:07 | 0:08:11 | |
of claims put forward | 0:08:11 | 0:08:13 | |
that we've seen in 23-24 years that I've been doing this. | 0:08:13 | 0:08:17 | |
It was rather simplistic in its approach, to be fair. | 0:08:17 | 0:08:21 | |
Brian was 100% certain that the damage to the Mercedes couldn't have | 0:08:22 | 0:08:27 | |
been caused by a single impact with the van, and reported his findings | 0:08:27 | 0:08:31 | |
back to the insurance company. | 0:08:31 | 0:08:33 | |
Shortly after we received the report from the forensic collision | 0:08:33 | 0:08:37 | |
investigator, we received a phone call from our customer, | 0:08:37 | 0:08:41 | |
asking what the progress had been on his claim. | 0:08:41 | 0:08:44 | |
During that call we advised our customer that we didn't believe | 0:08:45 | 0:08:49 | |
all of the damage to his vehicle was related to this accident, | 0:08:49 | 0:08:53 | |
and that we wouldn't be settling his claim. | 0:08:53 | 0:08:55 | |
Suspecting the claim was fraudulent, LV reported it to the police. | 0:08:56 | 0:09:01 | |
After being interviewed by the police, | 0:09:02 | 0:09:04 | |
our customer admitted an offence of fraud by false representation, | 0:09:04 | 0:09:08 | |
and he was given a police caution for this. | 0:09:08 | 0:09:11 | |
This means that he's now got a criminal record. | 0:09:11 | 0:09:14 | |
He agreed to pay £1,000 compensation | 0:09:14 | 0:09:16 | |
to LV and, in addition to all this, | 0:09:16 | 0:09:19 | |
he'd also smashed up his £13,500 Mercedes. | 0:09:19 | 0:09:23 | |
This man's attempt to go at it hammer and tongs had not only | 0:09:23 | 0:09:27 | |
damaged his precious car, | 0:09:27 | 0:09:29 | |
but left his bank balance in the red. | 0:09:29 | 0:09:32 | |
It was another victory for the insurers, | 0:09:32 | 0:09:35 | |
but one which left a bitter taste in their mouths. | 0:09:35 | 0:09:38 | |
Whilst the majority of claims are genuine, | 0:09:38 | 0:09:41 | |
false claims such as this are a problem. | 0:09:41 | 0:09:44 | |
They drive up the premiums for everyone, | 0:09:44 | 0:09:46 | |
and ultimately everybody foots the bill for that. | 0:09:46 | 0:09:48 | |
The insurance industry and the police, though, are determined to | 0:09:49 | 0:09:53 | |
tackle this kind of behaviour. | 0:09:53 | 0:09:54 | |
And anyone caught committing this kind of fraud | 0:09:54 | 0:09:57 | |
can expect prosecution, maybe even a criminal record. | 0:09:57 | 0:10:01 | |
Now, when it comes to motor insurance claims, it's becoming | 0:10:07 | 0:10:11 | |
increasingly common that the damage caused in a crash | 0:10:11 | 0:10:13 | |
just doesn't match up with the description of the accident itself. | 0:10:13 | 0:10:17 | |
As we've just seen, insurance companies are turning to forensic | 0:10:17 | 0:10:21 | |
experts to examine the vehicles involved in suspicious claims, | 0:10:21 | 0:10:24 | |
and determine if the given circumstances are correct | 0:10:24 | 0:10:28 | |
or whether the claimant is trying to pull a fast one. | 0:10:28 | 0:10:31 | |
Now, if, like me, you're wondering how these experts can tell | 0:10:35 | 0:10:38 | |
the difference between a real crash and one that's been exaggerated, | 0:10:38 | 0:10:42 | |
or even made up entirely, then now's your chance to find out. | 0:10:42 | 0:10:46 | |
We are a forensic investigation company dealing with engineering | 0:10:47 | 0:10:51 | |
motor vehicles, in particular. | 0:10:51 | 0:10:53 | |
And we provide expert evidence on | 0:10:53 | 0:10:56 | |
all manner of things - collisions, mechanical failures, | 0:10:56 | 0:11:00 | |
fires - for the benefit of the court, ultimately. | 0:11:00 | 0:11:04 | |
The experts at GBB all have mechanical engineering degrees | 0:11:04 | 0:11:08 | |
or equivalent. | 0:11:08 | 0:11:10 | |
Right the way up through to doctorates of engineering. | 0:11:10 | 0:11:13 | |
We all have different specialisms. | 0:11:13 | 0:11:16 | |
Mine happens to be relating to low speed and whiplash. | 0:11:16 | 0:11:20 | |
Brian and his team had given the claimant's version of events, | 0:11:21 | 0:11:25 | |
and were asked to match these up with the actual damage to the vehicles. | 0:11:25 | 0:11:28 | |
Well, in any claim, we try to think that actually the matter | 0:11:30 | 0:11:33 | |
is legitimate, for starters, | 0:11:33 | 0:11:35 | |
and we will try and look for evidence to support the fact | 0:11:35 | 0:11:38 | |
that it is legitimate. | 0:11:38 | 0:11:39 | |
If we then cannot find that, | 0:11:39 | 0:11:41 | |
we look for the evidence to try and support that it is fraudulent. | 0:11:41 | 0:11:45 | |
With fraudulent claims becoming increasingly frequent, | 0:11:46 | 0:11:49 | |
GBB set up their own unique crash testing programme, | 0:11:49 | 0:11:54 | |
so they can better understand how the vehicles involved in a crash | 0:11:54 | 0:11:57 | |
interact with each other. | 0:11:57 | 0:11:58 | |
We are very, very good now at determining how damage was caused. | 0:12:00 | 0:12:05 | |
So, in other words, at the moment that the other two vehicles come | 0:12:05 | 0:12:08 | |
together, we are very, very good at being able to tell you | 0:12:08 | 0:12:11 | |
precisely how they came together. The angle that they came together, | 0:12:11 | 0:12:15 | |
what they were doing at the moments that they came together. | 0:12:15 | 0:12:18 | |
Over the years, they've seen certain trends emerge when | 0:12:21 | 0:12:24 | |
it comes to fraudulent claims. | 0:12:24 | 0:12:26 | |
We initially used to get staged collisions. | 0:12:27 | 0:12:30 | |
So, individual collisions with numerous people in them, | 0:12:30 | 0:12:33 | |
so that actually it was a single high-value claim. | 0:12:33 | 0:12:36 | |
What we find now with organised frauds is, particularly, is | 0:12:38 | 0:12:41 | |
a series of lower value claims, | 0:12:41 | 0:12:43 | |
perhaps in the hope that they're not investigated as rigorously as | 0:12:43 | 0:12:49 | |
a higher value claim would be. | 0:12:49 | 0:12:51 | |
With thorough testing of their own vehicles in accident reconstructions, | 0:12:51 | 0:12:55 | |
they're able to catch out the fraudsters, | 0:12:56 | 0:12:59 | |
no matter what their game is. | 0:12:59 | 0:13:01 | |
I think the current trend towards slam-ons and so forth, | 0:13:01 | 0:13:05 | |
and inducing collisions from others, is a very, very dangerous practice. | 0:13:05 | 0:13:09 | |
I don't think for one minute any regard is given. | 0:13:09 | 0:13:12 | |
Frankly, it's reckless. | 0:13:13 | 0:13:14 | |
And it's only by good luck that somebody's not seriously injured | 0:13:15 | 0:13:19 | |
in some of these cases. | 0:13:19 | 0:13:21 | |
A victim's statement holds the key to a dubious claim. | 0:13:28 | 0:13:31 | |
Every year, insurance companies receive around 130,000 | 0:13:43 | 0:13:47 | |
fraudulent claims. | 0:13:47 | 0:13:49 | |
With figures steadily increasing, | 0:13:49 | 0:13:51 | |
insurers are investing millions of pounds to identify | 0:13:51 | 0:13:54 | |
these claims and catch the people behind them. | 0:13:54 | 0:13:57 | |
However, when fraudulent claims are made against a state-run system, | 0:13:57 | 0:14:01 | |
it means the cost of fraud is being funded by us - the taxpayers. | 0:14:01 | 0:14:06 | |
The UK is home to 150 prisons, | 0:14:10 | 0:14:13 | |
housing around 86,000 prisoners. | 0:14:13 | 0:14:16 | |
But if you think this would be the last place to find a fraudulent | 0:14:17 | 0:14:21 | |
claim, then you'd be sorely mistaken. | 0:14:21 | 0:14:23 | |
Richard Vince is responsible for eight high security prisons | 0:14:24 | 0:14:28 | |
in England and Wales. | 0:14:28 | 0:14:29 | |
He knows just how common fraud in prisons can be, | 0:14:30 | 0:14:33 | |
and the wider impact this can have. | 0:14:33 | 0:14:36 | |
Fraudulent claims within prisons are a problem, | 0:14:36 | 0:14:41 | |
in the same way that fraudulent claims made outside a prison is a problem. | 0:14:41 | 0:14:45 | |
You know, that comes at a cost to society within the prison service. | 0:14:45 | 0:14:49 | |
But this isn't the only reason why claims made in prisons need to be investigated. | 0:14:51 | 0:14:56 | |
It's important to fight the claims from two perspectives, really. | 0:14:56 | 0:14:59 | |
The first is, it's ongoing criminality from somebody who is | 0:14:59 | 0:15:02 | |
already in prison for criminality. | 0:15:02 | 0:15:05 | |
And secondly, it comes at a cost to the public purse, | 0:15:05 | 0:15:08 | |
and that detracts | 0:15:08 | 0:15:11 | |
valuable resource away from the ambitious reform programmes | 0:15:11 | 0:15:14 | |
that we're under way at the moment, | 0:15:14 | 0:15:16 | |
and our ability to reduce reoffending. | 0:15:16 | 0:15:18 | |
And that has a very direct impact on public safety. | 0:15:18 | 0:15:21 | |
Sarah McCracken deals with litigation for the high security prisons, | 0:15:22 | 0:15:26 | |
and worked on a case at HMP Manchester back in 2012. | 0:15:26 | 0:15:31 | |
The initial claim that came in was that the prisoner had slipped | 0:15:31 | 0:15:35 | |
on a wet patch on the stairs. | 0:15:35 | 0:15:37 | |
He'd fallen, hurting his lower back and his elbow. | 0:15:37 | 0:15:40 | |
He was claiming of chronic back pain | 0:15:40 | 0:15:43 | |
that was continued right up until the date | 0:15:43 | 0:15:45 | |
that he put the claim in. | 0:15:45 | 0:15:47 | |
Also, his injury to his elbow was quite serious as well, | 0:15:47 | 0:15:50 | |
by all accounts. | 0:15:50 | 0:15:52 | |
An unfortunate accident resulting in quite serious injuries, | 0:15:52 | 0:15:56 | |
a claim that was likely to cost the prison service around £3,000. | 0:15:56 | 0:16:01 | |
When the claim first came in, | 0:16:01 | 0:16:03 | |
we treated it as an absolutely genuine claim, | 0:16:03 | 0:16:05 | |
we had no reason to believe at that stage | 0:16:05 | 0:16:07 | |
that there was anything untoward. | 0:16:07 | 0:16:10 | |
The prison service began an investigation, which looked into | 0:16:10 | 0:16:13 | |
the allegations made by the prisoner. | 0:16:13 | 0:16:15 | |
As he had been injured in the fall, | 0:16:15 | 0:16:17 | |
the first step was to have a look at his medical records. | 0:16:17 | 0:16:20 | |
In this case, two medical experts were consulted. | 0:16:20 | 0:16:23 | |
One was a GP, one was an orthopaedic consultant. | 0:16:23 | 0:16:26 | |
The GP's report was extremely helpful towards the claimant's case. | 0:16:26 | 0:16:31 | |
He did think that the injury was consistent with a slip on water, | 0:16:31 | 0:16:37 | |
and the pain that he was still in was as a direct result of that accident. | 0:16:37 | 0:16:41 | |
It looked like the prison service would be paying out for the claim. | 0:16:41 | 0:16:45 | |
Until an interesting discrepancy popped up. | 0:16:45 | 0:16:48 | |
The claimant had stated to the GP that he was unable to work. | 0:16:48 | 0:16:53 | |
We knew from our own prison records that he was currently working | 0:16:53 | 0:16:56 | |
and employed as a wing cleaner. | 0:16:56 | 0:16:59 | |
The prisoner had claimed his injuries were so severe he'd been | 0:16:59 | 0:17:02 | |
unable to work. | 0:17:02 | 0:17:04 | |
Yet records show that he had continued with his prison job | 0:17:04 | 0:17:06 | |
after the accident had taken place. | 0:17:06 | 0:17:09 | |
And when the orthopaedic consultant's report came back, | 0:17:11 | 0:17:14 | |
it cast a shadow over the case. | 0:17:14 | 0:17:16 | |
He was able to interrogate the background medical evidence, | 0:17:16 | 0:17:20 | |
and found that the claimant did have a quite extensive history | 0:17:20 | 0:17:23 | |
of lower back pain and Sciatica. | 0:17:23 | 0:17:26 | |
The consultant had spotted that the back pain had been a problem for | 0:17:26 | 0:17:29 | |
some time before the accident. | 0:17:29 | 0:17:32 | |
So, the prison service decided to investigate, | 0:17:32 | 0:17:35 | |
and got their solicitors involved. | 0:17:35 | 0:17:37 | |
There were a few things that caused us to pause and think further | 0:17:37 | 0:17:40 | |
investigations were necessary. | 0:17:40 | 0:17:42 | |
Firstly, the accident location. | 0:17:42 | 0:17:44 | |
It appeared unlikely that anyone would have been in that location, | 0:17:44 | 0:17:47 | |
and therefore that liquid could have been spilt | 0:17:47 | 0:17:49 | |
since it was last cleaned. | 0:17:49 | 0:17:51 | |
In addition, the claimant was in fact a cleaner within the prison. | 0:17:52 | 0:17:56 | |
To some extent, therefore, | 0:17:56 | 0:17:58 | |
it was his responsibility to ensure that the location was clean. | 0:17:58 | 0:18:02 | |
It's also the case that he perhaps should have been better able | 0:18:02 | 0:18:05 | |
to identify the hazard in this particular location, | 0:18:05 | 0:18:08 | |
if it had been there. | 0:18:08 | 0:18:10 | |
Henry and his team then turned to the prison staff to see if they | 0:18:12 | 0:18:15 | |
could shed any light on the matter. | 0:18:15 | 0:18:18 | |
We took two witness statements from two prison officers. | 0:18:19 | 0:18:22 | |
The first officer was an officer who the claimant said he'd spoken to | 0:18:22 | 0:18:26 | |
after the accident took place. | 0:18:26 | 0:18:28 | |
That officer had no recollection of that conversation. | 0:18:28 | 0:18:30 | |
The second prison officer we approached gave a helpful statement | 0:18:30 | 0:18:34 | |
in relation to the accident location. | 0:18:34 | 0:18:36 | |
Essentially backing up our version of events | 0:18:36 | 0:18:38 | |
that this was not a location that was likely to have been | 0:18:38 | 0:18:41 | |
accessed by anyone else overnight whilst prisoners | 0:18:41 | 0:18:43 | |
were locked in their cells, or in the period since the location | 0:18:43 | 0:18:46 | |
was last cleaned. | 0:18:46 | 0:18:47 | |
So, let me see if I've got this straight. | 0:18:49 | 0:18:51 | |
One, the prisoner was claiming he was unable to work due to his injuries, | 0:18:51 | 0:18:55 | |
yet he continued to be employed by the prison service as a cleaner. | 0:18:55 | 0:18:59 | |
Two, he had a history of back pain | 0:18:59 | 0:19:01 | |
that started long before the accident had occurred. | 0:19:01 | 0:19:05 | |
And three, on the day of the accident, | 0:19:05 | 0:19:07 | |
the prisoner was the first person to use the staircase, | 0:19:07 | 0:19:11 | |
making it extremely unlikely there was even any liquid | 0:19:11 | 0:19:14 | |
for him to slip on. | 0:19:14 | 0:19:17 | |
Looking at all the evidence, | 0:19:17 | 0:19:18 | |
there appeared to be very little to support the claimant's case. | 0:19:18 | 0:19:22 | |
And therefore, we thought we were in a very strong position to take | 0:19:22 | 0:19:25 | |
this case to trial. | 0:19:25 | 0:19:27 | |
13 months after the claim had been made, | 0:19:27 | 0:19:29 | |
a hearing took place at Manchester Civil Justice Centre. | 0:19:29 | 0:19:33 | |
It's fair to say that the claimant was not strong in his evidence | 0:19:33 | 0:19:37 | |
at trial. He struggled as to whether he'd fallen down 12 steps, | 0:19:37 | 0:19:40 | |
or two steps. | 0:19:40 | 0:19:42 | |
He was also in difficulties when presented with his | 0:19:42 | 0:19:45 | |
medical and employment history, | 0:19:45 | 0:19:47 | |
to such an extent that his own barrister later described him | 0:19:47 | 0:19:51 | |
as a poor historian. | 0:19:51 | 0:19:53 | |
The claim was dismissed, | 0:19:53 | 0:19:55 | |
and the prisoner was ordered to pay £9,000 in legal costs | 0:19:55 | 0:19:58 | |
to the Prison Service. | 0:19:58 | 0:20:00 | |
In this case, we thought it was the right result, | 0:20:01 | 0:20:03 | |
that it was entirely in line with the evidence the judge had seen, | 0:20:03 | 0:20:06 | |
and that he took the right decision in dismissing the claim and finding | 0:20:06 | 0:20:10 | |
no fault on the part of the Prison Service. | 0:20:10 | 0:20:12 | |
So, a great result all-round. | 0:20:13 | 0:20:16 | |
And if the legal costs weren't a big enough price to pay, | 0:20:16 | 0:20:19 | |
three years after his release, this con artist really got his comeuppance. | 0:20:19 | 0:20:24 | |
Despite claiming he couldn't work after the accident, | 0:20:24 | 0:20:27 | |
he was later employed as a builder. | 0:20:27 | 0:20:30 | |
He was climbing a ladder when he was the victim of a genuine accident. | 0:20:30 | 0:20:35 | |
The ladder slipped, causing him to crash to the ground. | 0:20:35 | 0:20:38 | |
He was hurt but not badly. | 0:20:38 | 0:20:41 | |
Now, I'm not sure if you believe in karma, but, | 0:20:41 | 0:20:44 | |
after watching this, | 0:20:44 | 0:20:46 | |
I think I might just be convinced. | 0:20:46 | 0:20:48 | |
All right, let's talk rear-end shunts. | 0:20:53 | 0:20:56 | |
Which, if you're wondering, isn't an elaborate dance move. | 0:20:56 | 0:20:59 | |
No, that's when one car hits another from behind. | 0:20:59 | 0:21:03 | |
Now, when this type of accident occurs, it's almost always | 0:21:03 | 0:21:06 | |
presumed the driver who crashed into the car in front | 0:21:06 | 0:21:08 | |
is at fault for not driving at a safe stopping distance. | 0:21:08 | 0:21:12 | |
But some fraudsters see these collisions as the perfect opportunity to | 0:21:12 | 0:21:16 | |
pull a fast one on insurers. | 0:21:16 | 0:21:18 | |
Insurance companies pay out around £28.6 million | 0:21:21 | 0:21:25 | |
in motor claims every day, | 0:21:25 | 0:21:27 | |
many of which are accidents involving rear-end collisions. | 0:21:27 | 0:21:30 | |
Whilst the majority of these are innocent mistakes, | 0:21:32 | 0:21:34 | |
some are far from accidental. | 0:21:34 | 0:21:36 | |
Allan Peak is a fraud manager at Markerstudy Insurance. | 0:21:38 | 0:21:42 | |
He received a call from a customer reporting a rather suspicious crash. | 0:21:42 | 0:21:46 | |
Our policyholder's version of events was that he was stationary | 0:21:48 | 0:21:53 | |
at traffic lights behind this vehicle. | 0:21:53 | 0:21:56 | |
The third party vehicle commenced on to the roundabout. | 0:21:56 | 0:22:00 | |
Our policyholder followed. | 0:22:00 | 0:22:02 | |
And then, suddenly, the third party brakes quite heavily. | 0:22:02 | 0:22:05 | |
The policyholder also brakes. | 0:22:05 | 0:22:08 | |
He was unable to stop in time, and he collided with the rear | 0:22:08 | 0:22:11 | |
of the claimant's vehicle at around 10mph. | 0:22:11 | 0:22:14 | |
After the collision, the policyholder spoke with | 0:22:16 | 0:22:20 | |
the third party, asked directly, "Why did you stop?" | 0:22:20 | 0:22:24 | |
There was no reason for them to stop quite so suddenly. | 0:22:24 | 0:22:27 | |
And the third-party passenger suggested that there was some | 0:22:27 | 0:22:30 | |
sat nav-related reason for that stop. | 0:22:30 | 0:22:34 | |
Now, I might be out of the loop, | 0:22:36 | 0:22:38 | |
but since when did a Sat Nav order a driver to make an emergency stop? | 0:22:38 | 0:22:42 | |
The policyholder was suspicious, | 0:22:44 | 0:22:46 | |
and immediately called his insurance company. | 0:22:46 | 0:22:48 | |
They then received a claim from the couple in the car in front. | 0:23:19 | 0:23:23 | |
But when asked for their account of the accident, the circumstances | 0:23:23 | 0:23:27 | |
they gave were completely different. | 0:23:27 | 0:23:30 | |
The third-party's version of events was that they were simply stationary | 0:23:30 | 0:23:34 | |
at the traffic lights for four or five seconds, | 0:23:34 | 0:23:36 | |
when our policyholder collided with the rear of the vehicle. | 0:23:36 | 0:23:39 | |
Hang on, I thought the accident happened on the roundabout, | 0:23:41 | 0:23:45 | |
not at the traffic lights? | 0:23:45 | 0:23:46 | |
And as for the claim itself, | 0:23:47 | 0:23:48 | |
it was far greater than the insurers had expected. | 0:23:48 | 0:23:51 | |
The claimant's version suggested a fairly significant impact | 0:23:54 | 0:23:57 | |
was sufficient to write the vehicle off | 0:23:57 | 0:24:00 | |
and cause personal injury to both occupants of the vehicle. | 0:24:00 | 0:24:03 | |
The insurers then asked for evidence to support the personal injury | 0:24:04 | 0:24:08 | |
claims, and subsequently received a report from an independent GP. | 0:24:08 | 0:24:12 | |
In the report, the claimant stated on a scale of one to ten, | 0:24:13 | 0:24:17 | |
her pain had been an eight. | 0:24:17 | 0:24:19 | |
She said that for eight weeks, sleep was disturbed to | 0:24:19 | 0:24:23 | |
the extent she had take sleeping pills. | 0:24:23 | 0:24:25 | |
She claimed that she was very anxious to the extent that she was | 0:24:25 | 0:24:28 | |
no longer able to drive a vehicle. | 0:24:28 | 0:24:30 | |
And she was unable to attend the scene of the accident again | 0:24:30 | 0:24:34 | |
because it gave her nightmares. | 0:24:34 | 0:24:36 | |
Well, that is a pretty big statement to make for someone whose car was | 0:24:36 | 0:24:40 | |
crashed into - and remember, at a low speed. | 0:24:40 | 0:24:44 | |
Overall, we estimated the value of the claims for injury | 0:24:44 | 0:24:47 | |
to be between £2,000 and £3,000 each. | 0:24:47 | 0:24:50 | |
So, along with the claims for vehicle damage and travel expenses, | 0:24:50 | 0:24:53 | |
we were looking at a claim that included third-party solicitor costs | 0:24:53 | 0:24:57 | |
of up to around £22,000 in total for both claimants. | 0:24:57 | 0:25:01 | |
Markerstudy then involved their own lawyers, DWF Solicitors, | 0:25:04 | 0:25:08 | |
and asked them to investigate the allegations of fraud. | 0:25:08 | 0:25:12 | |
From the outset of this, it's quite clear there's a discrepancy | 0:25:12 | 0:25:15 | |
in the two accounts that have been provided. | 0:25:15 | 0:25:18 | |
Ordinarily, we would assume that any person who drives into the rear | 0:25:18 | 0:25:21 | |
of someone else would naturally be at fault for the accident. | 0:25:21 | 0:25:25 | |
That's generally an accepted principle. | 0:25:25 | 0:25:27 | |
The quirk to this case is that the defendant's suggesting that | 0:25:27 | 0:25:30 | |
the claimant has stopped deliberately. So, actually, | 0:25:30 | 0:25:33 | |
the defendant is alleging that the claimant driver is at fault for | 0:25:33 | 0:25:35 | |
the collision. Obviously, that's not what the claimant is saying. | 0:25:35 | 0:25:38 | |
The claimant is saying "No, you've hit me in the rear, | 0:25:38 | 0:25:40 | |
"therefore, you should be held at fault." | 0:25:40 | 0:25:42 | |
To get to the bottom of exactly who was at fault, | 0:25:42 | 0:25:45 | |
the solicitors turned to a witness who had been following both vehicles | 0:25:45 | 0:25:48 | |
at the time of the accident. | 0:25:48 | 0:25:50 | |
The independent witness was supportive of the defendant's | 0:25:50 | 0:25:54 | |
version of events. He had the fortunate view of being in a lorry, | 0:25:54 | 0:25:58 | |
so he could see in front of both vehicles, | 0:25:58 | 0:26:01 | |
and was able to say quite clearly that the claimant | 0:26:01 | 0:26:03 | |
had stopped without apparent reason, | 0:26:03 | 0:26:05 | |
and not only that, stopped very abruptly, | 0:26:05 | 0:26:08 | |
which again supported the broad principle of our defendant | 0:26:08 | 0:26:11 | |
saying that he had been deliberately induced. | 0:26:11 | 0:26:13 | |
DWF had now gathered enough evidence | 0:26:15 | 0:26:18 | |
to prove that the couple in front were at fault, | 0:26:18 | 0:26:22 | |
and decided to take the case to court. | 0:26:22 | 0:26:24 | |
But on the day of the trial, the claimant failed to turn up. | 0:26:24 | 0:26:28 | |
The big inference we were able to draw from their lack of attendance | 0:26:28 | 0:26:32 | |
was that we'd hit the nail on the head, | 0:26:32 | 0:26:34 | |
and the allegations obviously had merit and weight. | 0:26:34 | 0:26:36 | |
The claim ended up being dismissed at hearing. | 0:26:36 | 0:26:39 | |
The judge granted the defendants nearly £7,000 | 0:26:39 | 0:26:42 | |
in respect of their own costs, | 0:26:42 | 0:26:44 | |
which were incurred during the defence of the claim. | 0:26:44 | 0:26:47 | |
A superb result all round. | 0:26:48 | 0:26:50 | |
In terms of the overall outcome of the case, we were very, very pleased | 0:26:50 | 0:26:54 | |
that Markerstudy avoided having to make any payments. | 0:26:54 | 0:26:56 | |
We were also confident that had a judge considered the case | 0:26:56 | 0:27:00 | |
and listened to the claimant's evidence, | 0:27:00 | 0:27:02 | |
then a judge would have found for us and established | 0:27:02 | 0:27:05 | |
that the claim had been induced. | 0:27:05 | 0:27:07 | |
Unfortunately, cases like this are becoming more and more common, | 0:27:07 | 0:27:11 | |
and it's the innocent victims who end up suffering the most. | 0:27:11 | 0:27:15 | |
It's vital for us to come combat this type of fraud and to identify | 0:27:15 | 0:27:19 | |
as many of these cases as we possibly can, and to subsequently defend them, | 0:27:19 | 0:27:22 | |
for a number of reasons. Most importantly of all, actually, | 0:27:22 | 0:27:26 | |
these type of collisions are putting innocent motorists at risk. | 0:27:26 | 0:27:30 | |
This was a minor impact, | 0:27:31 | 0:27:32 | |
but how much would it take for one of these to go wrong and for | 0:27:32 | 0:27:35 | |
serious damage and injury to be caused to an innocent motorist? | 0:27:35 | 0:27:38 | |
Still to come... | 0:27:44 | 0:27:45 | |
A conniving couple are caught out when they make a comedy of errors. | 0:27:45 | 0:27:50 | |
She showed little or no emotion in regard to the fact that | 0:27:50 | 0:27:53 | |
he'd just been held at knife-point and had numerous items of | 0:27:53 | 0:27:56 | |
significant value stolen from her home. | 0:27:56 | 0:27:59 | |
We are a nation of pet lovers, | 0:28:04 | 0:28:06 | |
with around 20% of us insuring our furry friends. | 0:28:06 | 0:28:10 | |
And it's no wonder why, as recent rises in vets' fees | 0:28:10 | 0:28:13 | |
means insurance companies are now paying out | 0:28:13 | 0:28:16 | |
£1.8 million in claims every single day. | 0:28:16 | 0:28:21 | |
Agria is one of the world's leading pet insurers, | 0:28:23 | 0:28:26 | |
and is well aware of the problem of insurance fraud. | 0:28:26 | 0:28:29 | |
So, before getting the cheque-book out, | 0:28:29 | 0:28:31 | |
they check and validate every claim that comes in. | 0:28:31 | 0:28:34 | |
Simon Wheeler, Agria's managing director, | 0:28:37 | 0:28:39 | |
tells us about a tricky case | 0:28:39 | 0:28:41 | |
they dealt with that concerns a poorly pup. | 0:28:41 | 0:28:43 | |
We received a call from our policyholder, who advised us | 0:28:45 | 0:28:48 | |
that his new Border terrier puppy | 0:28:48 | 0:28:50 | |
had had an accident in the evening, had broken its leg, | 0:28:50 | 0:28:54 | |
and they'd had to rush it to the out of hours emergency vets. | 0:28:54 | 0:28:57 | |
It looked like a clear-cut case. | 0:30:03 | 0:30:05 | |
The accident had happened before the policy had started, | 0:30:05 | 0:30:08 | |
so, unfortunately, the customer wasn't covered. | 0:30:08 | 0:30:11 | |
We then had yet another call from the owner, two hours later, | 0:30:11 | 0:30:15 | |
and he'd revised some of his facts. | 0:30:15 | 0:30:17 | |
He'd made a phone call to the vet, | 0:30:17 | 0:30:19 | |
and he'd made a phone call to his father, and his father had | 0:30:19 | 0:30:22 | |
categorically advised him that the puppy had injured | 0:30:22 | 0:30:25 | |
itself at ten o'clock and, so, no, | 0:30:25 | 0:30:28 | |
that was well and truly after the policy had been set up. | 0:30:28 | 0:30:30 | |
So, having initially claimed that the puppy broke its leg around 9pm, | 0:30:42 | 0:30:46 | |
the policyholder had now changed his story to say that it had happened | 0:30:46 | 0:30:50 | |
around 10pm, conveniently, after the policy had been put in place, | 0:30:50 | 0:30:55 | |
and when the insurance had become valid. | 0:30:55 | 0:30:58 | |
So, the next we heard from the policyholder was when the claim came through. | 0:30:58 | 0:31:02 | |
A claim for £1,100. | 0:31:02 | 0:31:04 | |
On the claim form were all the latest set of details. | 0:31:04 | 0:31:08 | |
The next step in the process was that we contacted the breeder, | 0:31:09 | 0:31:12 | |
just to verify what had been said in the claim form. | 0:31:12 | 0:31:15 | |
And the details they gave us exactly matched the details in the claim form. | 0:31:15 | 0:31:20 | |
They were like a script, down to the letter. | 0:31:20 | 0:31:22 | |
Could the owner and the breeder have spoken to align their stories? | 0:31:26 | 0:31:30 | |
Or was the insurance company barking up the wrong tree? | 0:31:30 | 0:31:34 | |
Agria decided to make contact with the vet to see if they had any | 0:31:34 | 0:31:38 | |
record of the timings for the evening in question. | 0:31:38 | 0:31:41 | |
If the owner was telling the truth, | 0:31:41 | 0:31:43 | |
the vet's record would show the consultation happening after 10pm. | 0:31:43 | 0:31:48 | |
The sequence of events would be, | 0:31:49 | 0:31:51 | |
animal was injured at about ten o'clock, | 0:31:51 | 0:31:53 | |
the owner would try to find an out-of-hours vet, | 0:31:53 | 0:31:56 | |
would go to the out of hours, the vet would see the animal, | 0:31:56 | 0:32:00 | |
and then probably write up the notes, the consult notes, | 0:32:00 | 0:32:02 | |
after treatment had been given. | 0:32:02 | 0:32:04 | |
The note was written up at 10.23pm, | 0:32:05 | 0:32:08 | |
so effectively tying in, possibly. | 0:32:08 | 0:32:12 | |
It was after the insurance had been set up but at a very, very short | 0:32:12 | 0:32:16 | |
timescale, so we needed to investigate further. | 0:32:16 | 0:32:19 | |
The insurers weren't going to let sleeping dogs lie, | 0:32:19 | 0:32:23 | |
and still needed proof of the time the owner had called the vets. | 0:32:23 | 0:32:27 | |
There was only one way of finding out. | 0:32:27 | 0:32:29 | |
Although we asked for phone records for the whole evening, | 0:32:54 | 0:32:57 | |
what the policyholder sent through | 0:32:57 | 0:33:00 | |
was a very precise, cropped phone record | 0:33:00 | 0:33:02 | |
that started at 10.01 and went onwards. | 0:33:02 | 0:33:06 | |
That period between nine and ten, | 0:33:06 | 0:33:08 | |
the potential contentious period, was completely missing. | 0:33:08 | 0:33:13 | |
And when we pushed the policyholder for the rest of the telephone records, | 0:33:13 | 0:33:17 | |
there were lots of excuses made why we couldn't have those. | 0:33:17 | 0:33:20 | |
Those phone records between nine and ten would have given us sufficient | 0:34:30 | 0:34:34 | |
evidence to say, "Yes, this is, of course, a valid claim." | 0:34:34 | 0:34:36 | |
In the absence of anything, | 0:34:36 | 0:34:39 | |
the doubt and suspicion very much is that the incident occurred | 0:34:39 | 0:34:42 | |
at nine o'clock, | 0:34:42 | 0:34:43 | |
and there were records on that phone bill that didn't, | 0:34:43 | 0:34:46 | |
didn't tie in with the revised story. | 0:34:46 | 0:34:49 | |
So, the final contact with the customer was that we e-mailed | 0:34:51 | 0:34:54 | |
them and asked for the full telephone records for that day, | 0:34:54 | 0:34:59 | |
and despite that e-mail, despite the conversation we'd had with them, | 0:34:59 | 0:35:03 | |
those records were never forthcoming, | 0:35:03 | 0:35:06 | |
so complete radio silence from the policyholder. | 0:35:06 | 0:35:08 | |
There is sufficient doubt for us to reject the claim. | 0:35:08 | 0:35:11 | |
The policyholder hasn't come forth with sufficient evidence to prove | 0:35:11 | 0:35:14 | |
that the changed story is actually the factual story, | 0:35:14 | 0:35:18 | |
so we rejected the claim. | 0:35:18 | 0:35:21 | |
Considering how easy it would have been to validate the claim had | 0:35:21 | 0:35:24 | |
the policyholder provided the earlier phone records, | 0:35:24 | 0:35:27 | |
their refusal to do so strongly suggested that this was indeed | 0:35:27 | 0:35:32 | |
a spurious claim. | 0:35:32 | 0:35:34 | |
Fraud isn't acceptable in any guise. | 0:35:34 | 0:35:37 | |
In this instance, it was a clumsy attempt to defraud us of money, | 0:35:37 | 0:35:40 | |
where the breeder made mistakes, where the new owner made mistakes. | 0:35:40 | 0:35:44 | |
Our claims assessors are hugely skilled at identifying fraud | 0:35:44 | 0:35:48 | |
in a much more sophisticated way. | 0:35:48 | 0:35:50 | |
Most claims come in, nothing changes, | 0:35:50 | 0:35:53 | |
the facts are clear and we pay the claims. | 0:35:53 | 0:35:55 | |
In instances like this, where times are changing - | 0:35:55 | 0:35:58 | |
huge indicators of fraud and then when they can't be backed up with | 0:35:58 | 0:36:01 | |
evidence, no, absolutely, they'll be outed every time. | 0:36:01 | 0:36:04 | |
Unfortunately, there are fraudsters out there who will sink | 0:36:10 | 0:36:13 | |
to diabolical depths to get their hands on a pay-out. | 0:36:13 | 0:36:17 | |
Even if it means concocting elaborate accounts | 0:36:17 | 0:36:20 | |
of traumatic events that never even happened. | 0:36:20 | 0:36:22 | |
But many of these criminals often make careless | 0:36:22 | 0:36:25 | |
mistakes, and when they're caught out, | 0:36:25 | 0:36:28 | |
the consequences of their actions | 0:36:28 | 0:36:30 | |
can be far greater than they ever imagined. | 0:36:30 | 0:36:33 | |
Tom Wilson is a Counter Fraud Manager at AXA, | 0:36:37 | 0:36:40 | |
and recently dealt with a rather distressing case. | 0:36:40 | 0:36:43 | |
So, on this occasion, we had a claim coming from Paul and Zoe Sizurk. | 0:36:45 | 0:36:49 | |
It was a household claim, where they claimed that they'd been held | 0:36:49 | 0:36:53 | |
at knife-point in their home, | 0:36:53 | 0:36:55 | |
whilst balaclava-clad thieves stole £17,000 worth of jewellery, | 0:36:55 | 0:37:00 | |
cash and a number of other items. | 0:37:00 | 0:37:02 | |
To be held at knife-point in your own home must be a pretty harrowing ordeal. | 0:37:02 | 0:37:08 | |
Everything, quick! Hurry up! | 0:37:08 | 0:37:10 | |
So it was important that they dealt with the Sizurks' claim as | 0:37:10 | 0:37:14 | |
quickly and efficiently as possible. | 0:37:14 | 0:37:16 | |
From the outset, with any claim that's reported to us, | 0:37:17 | 0:37:20 | |
we treat them as genuine | 0:37:20 | 0:37:21 | |
unless there's reason to suggest otherwise. | 0:37:21 | 0:37:23 | |
In this particular instance, | 0:37:23 | 0:37:25 | |
the concern that was initially raised was when we spoke to Zoe | 0:37:25 | 0:37:28 | |
on the phone when she reported the incident. | 0:37:28 | 0:37:30 | |
She showed little or no emotion in regards to the fact that she'd just | 0:37:32 | 0:37:36 | |
been held at knife-point and had numerous items of significant value | 0:37:36 | 0:37:39 | |
stolen from her home. | 0:37:39 | 0:37:40 | |
Zoe was obviously concerned about the missing cash and jewellery, | 0:38:34 | 0:38:39 | |
but didn't paint a picture of a woman who'd just been robbed | 0:38:39 | 0:38:42 | |
at knife-point. | 0:38:42 | 0:38:43 | |
With claims of this nature, it's our standard practice | 0:38:43 | 0:38:46 | |
to appoint one of our partner loss adjusters, | 0:38:46 | 0:38:49 | |
who would attend upon the premises of the customer | 0:38:49 | 0:38:52 | |
to run through the details of what happened, what was stolen, etc. | 0:38:52 | 0:38:55 | |
When our adjuster met with Zoe, she asked her what happened. | 0:38:58 | 0:39:02 | |
At no point did she mention that her and her husband had been held at | 0:39:02 | 0:39:05 | |
knife-point in their home whilst these thieves ransacked the house | 0:39:05 | 0:39:09 | |
and stole this jewellery. | 0:39:09 | 0:39:11 | |
Something really odd, given the experience | 0:39:11 | 0:39:13 | |
that they alleged to have been through. | 0:39:13 | 0:39:15 | |
You would've thought that it's the first thing that they'd mention. | 0:39:15 | 0:39:19 | |
Already, the circumstances seem a little suspicious, | 0:39:19 | 0:39:23 | |
but AXA were prepared to give the Sizurks the benefit of the doubt. | 0:39:23 | 0:39:27 | |
It was only when Zoe listed the items that had been stolen | 0:39:27 | 0:39:30 | |
to the loss adjuster that the true nature of the claim became apparent. | 0:39:30 | 0:39:35 | |
More alarming was that during the course of the meeting, | 0:39:36 | 0:39:39 | |
some of the items she claimed that had been stolen, | 0:39:39 | 0:39:42 | |
she was actually wearing. | 0:39:42 | 0:39:43 | |
Hold on - you'd think if someone was claiming for stolen jewellery, | 0:39:48 | 0:39:51 | |
surely they wouldn't wear it during an interview | 0:39:51 | 0:39:54 | |
with the person handling the claim. | 0:39:54 | 0:39:57 | |
So, the loss adjuster reported back, and investigators decided to | 0:39:57 | 0:40:01 | |
interview Zoe's husband to try and suss out whether the claim | 0:40:01 | 0:40:05 | |
could in any way be genuine. | 0:40:05 | 0:40:08 | |
Our adjuster contacted us to advise us of the concerns. | 0:40:08 | 0:40:12 | |
We arranged to meet with Paul, Zoe's husband, | 0:40:12 | 0:40:15 | |
to get his account as well, and during that meeting, | 0:40:15 | 0:40:18 | |
Zoe was present and, again, | 0:40:18 | 0:40:20 | |
Paul didn't mention the robbery at all and it wasn't until Zoe | 0:40:20 | 0:40:23 | |
prompted him that he mentioned it. | 0:40:23 | 0:40:25 | |
Although the couple's story matched up, | 0:40:26 | 0:40:29 | |
the insurers still didn't know if the robbery had actually taken place, | 0:40:29 | 0:40:33 | |
and, even if it had, £17,000 worth of goods | 0:40:33 | 0:40:36 | |
was a lot to be claiming for. | 0:40:36 | 0:40:39 | |
With incidents of this nature, | 0:40:39 | 0:40:41 | |
we would always ask for proof of purchase. | 0:40:41 | 0:40:43 | |
We need to ensure that the items being claimed | 0:40:43 | 0:40:46 | |
were actually purchased in the first instance | 0:40:46 | 0:40:48 | |
and were owned by the customer. | 0:40:48 | 0:40:50 | |
On this occasion, a number of the items she claimed to have been | 0:40:50 | 0:40:53 | |
stolen, they just couldn't provide proof of purchase for. | 0:40:53 | 0:40:56 | |
So, following the concerns that we identified, | 0:40:59 | 0:41:02 | |
and the clear discrepancies, | 0:41:02 | 0:41:03 | |
we put these to Zoe and Paul and they weren't able to provide | 0:41:03 | 0:41:08 | |
a reasonable explanation as to these discrepancies, | 0:41:08 | 0:41:10 | |
and that led to us making a decision to not pay the claim. | 0:41:10 | 0:41:14 | |
AXA contacted the police, | 0:41:14 | 0:41:16 | |
who later arrested the couple at their home. | 0:41:16 | 0:41:19 | |
Yet again, Zoe was wearing some of the pieces | 0:41:19 | 0:41:21 | |
of jewellery she claimed had been taken in the robbery. | 0:41:21 | 0:41:25 | |
Following the arrest of Paul and Zoe, the police charged them | 0:41:25 | 0:41:28 | |
with fraud by false representation. | 0:41:28 | 0:41:31 | |
Both pled guilty to the charge and a hearing date for their sentencing was set. | 0:41:31 | 0:41:35 | |
But when that date arrived - yup, you guessed it - | 0:41:35 | 0:41:39 | |
Paul and Zoe didn't turn up to court. | 0:41:39 | 0:41:41 | |
They were arrested at Manchester Airport, | 0:41:43 | 0:41:45 | |
where they were trying to flee the country, | 0:41:45 | 0:41:47 | |
but there was no escaping the long arm of the law. | 0:41:47 | 0:41:50 | |
On that date, they attended the sentencing hearing | 0:41:50 | 0:41:53 | |
and were both handed down 16 months behind bars. | 0:41:53 | 0:41:56 | |
The fact that they didn't attend the sentencing hearing that was | 0:42:00 | 0:42:03 | |
originally set, and were then later arrested at the airport, | 0:42:03 | 0:42:06 | |
suggested they had no intention of attending the hearing, | 0:42:06 | 0:42:09 | |
and my view is that that probably contributed to the | 0:42:09 | 0:42:12 | |
very serious nature of the sentence they did eventually receive. | 0:42:12 | 0:42:16 | |
Ultimately, this couple discovered that crime really doesn't pay. | 0:42:17 | 0:42:22 | |
The outcome of the custodial sentence - brilliant result. | 0:42:22 | 0:42:25 | |
It goes to show that the courts are prepared to hand out some | 0:42:25 | 0:42:28 | |
fairly hard sentences to would-be fraudsters, | 0:42:28 | 0:42:31 | |
and it should act as a deterrent for anybody considering | 0:42:31 | 0:42:33 | |
submitting a fraudulent claim. | 0:42:33 | 0:42:35 | |
Whether it's exaggerating real injuries, | 0:42:41 | 0:42:43 | |
totally making up a story for a dodgy claim | 0:42:43 | 0:42:46 | |
or masterminding insurance fraud on an industrial scale, | 0:42:46 | 0:42:49 | |
the law is coming down hard on the people who think they can | 0:42:49 | 0:42:53 | |
make a quick buck with their insurance scams and cons. | 0:42:53 | 0:42:56 | |
But the fraudsters need to think again, as more of them than | 0:42:56 | 0:42:59 | |
ever before are being caught in the act and claimed and shamed. | 0:42:59 | 0:43:03 |