0:00:06 > 0:00:10Insurance fraud in the UK has hit epidemic levels.
0:00:10 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:18That's almost £3.6 million every day.
0:00:19 > 0:00:24Deliberate crashes, bogus personal injuries, even 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 just under 15 fake claims every hour.
0:00:39 > 0:00:41Armed with covert surveillance systems...
0:00:41 > 0:00:44Subject out of the vehicle.
0:00:44 > 0:00:47..sophisticated data analysis techniques...
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 > 0:00:58Just don't lie to us.
0:00:58 > 0:01:01All those conmen, scammers and cheats on the fiddle
0:01:01 > 0:01:05are now caught in the act and claimed and shamed.
0:01:10 > 0:01:13A couple are all shook up
0:01:13 > 0:01:15as they fail to get their stories straight...
0:01:15 > 0:01:18In terms of the person they were visiting,
0:01:18 > 0:01:20neither of them knew really who it was.
0:01:20 > 0:01:25They could only say that it was Elvis from Enfield.
0:01:25 > 0:01:28..a would-be fraudster can't handle the pressure
0:01:28 > 0:01:30when questioned by his insurers...
0:01:30 > 0:01:32When we pushed further,
0:01:32 > 0:01:35the customer actually admitted that they had taken the policy out
0:01:35 > 0:01:38after the incident actually happened.
0:01:38 > 0:01:41..and a bogus travel insurance claim runs out of steam
0:01:41 > 0:01:44thanks to some shocking spelling.
0:01:44 > 0:01:47There was a glaringly obvious spelling mistake
0:01:47 > 0:01:50where the doctor had referred to what he believed should have been
0:01:50 > 0:01:53"wheezing" but he had put "whezzing".
0:01:57 > 0:01:59Nowadays, for many of us,
0:01:59 > 0:02:03there is one thing that is almost always by our side,
0:02:03 > 0:02:05apart from a four-legged friend, maybe.
0:02:05 > 0:02:08I'm of course talking about our mobile phones.
0:02:08 > 0:02:11With smartphones enabling us to do everything
0:02:11 > 0:02:14from making a simple phone call to online shopping,
0:02:14 > 0:02:17catching up with e-mails and working on the go,
0:02:17 > 0:02:21for many of us, these are an omnipresent companion.
0:02:21 > 0:02:23But as good as they are, their delicate nature
0:02:23 > 0:02:26can sometimes be their undoing.
0:02:27 > 0:02:32Mobile phone insurance policies can protect our hi-tech handsets
0:02:32 > 0:02:34in the event of disaster.
0:02:34 > 0:02:37However, they aren't something that can be taken out
0:02:37 > 0:02:39as and when required.
0:02:39 > 0:02:42Someone who's had plenty of experience of this
0:02:42 > 0:02:46kind of fraudulent behaviour is Simon Powell at insurers Endsleigh.
0:02:47 > 0:02:50The customer took out a policy online.
0:02:50 > 0:02:53They then made a claim online.
0:02:53 > 0:02:55But due to the circumstances,
0:02:55 > 0:02:57this was a claim with a bit of a difference.
0:02:58 > 0:03:02Along with some friends, they'd been along to Thorpe Park for the day.
0:03:02 > 0:03:04They've been on a ride called Tidal Wave.
0:03:06 > 0:03:09The customer had their mobile phone in their pocket and during the ride,
0:03:09 > 0:03:11water had come over the side,
0:03:11 > 0:03:14got onto the customer's lap and as a result of that,
0:03:14 > 0:03:18the customer comes off the ride, and the phone has got water damage.
0:03:18 > 0:03:21Top-of-the-range smartphones and water
0:03:21 > 0:03:23are a particularly precarious combination
0:03:23 > 0:03:26so unlike the people on the ride,
0:03:26 > 0:03:29the phone wasn't OK once it had dried out.
0:03:29 > 0:03:30Took it along to the repair shop
0:03:30 > 0:03:33because it wasn't working, and the repair shop confirmed
0:03:33 > 0:03:35that it was beyond economical repair.
0:03:35 > 0:03:39So, we had a claim for a damaged phone
0:03:39 > 0:03:42which was brand-new and worth £619.
0:03:43 > 0:03:46Now, the theme park enthusiasts amongst us will know that
0:03:46 > 0:03:50rides like this one are designed to give people a proper drenching.
0:03:52 > 0:03:55So, with the claimant's version of events sounding plausible enough,
0:03:55 > 0:03:57Endsleigh began to settle the claim.
0:03:57 > 0:04:00It seemed legitimate. There was nothing around
0:04:00 > 0:04:03the accident circumstances or incident circumstances that lacked
0:04:03 > 0:04:04any credibility at all.
0:04:04 > 0:04:07You know, it is quite clear that this just looked as though it was
0:04:07 > 0:04:11something that happened during a normal day out with their friends.
0:04:11 > 0:04:12Well, that's that, then.
0:04:12 > 0:04:15Um, hold that thought.
0:04:15 > 0:04:19So, the suspicions weren't around the incident circumstances.
0:04:19 > 0:04:22It was more in terms of the fraud indicators that we had in place
0:04:22 > 0:04:24in the background that confirmed that the policy was taken out
0:04:24 > 0:04:27the day before the incident.
0:04:27 > 0:04:30Of course, it's not impossible and it does happen,
0:04:30 > 0:04:33but needing to make a claim so soon after taking out an insurance policy
0:04:33 > 0:04:36is a rare occurrence, so when it does happen,
0:04:36 > 0:04:40insurers will usually make some additional checks to ensure that
0:04:40 > 0:04:44everything is above board, and that's exactly what Endsleigh did.
0:04:45 > 0:04:47On the further investigation,
0:04:47 > 0:04:50we also looked at the details that the customer provided
0:04:50 > 0:04:52when they took out the policy.
0:04:52 > 0:04:54And there was one real discrepancy around it,
0:04:54 > 0:04:57which related to the contact details.
0:04:57 > 0:05:00Because the customer hadn't put on their permanent mobile number,
0:05:00 > 0:05:04and the number that they were actually making the claim for
0:05:04 > 0:05:07on the inception details, they had actually put forward a temporary number.
0:05:07 > 0:05:11And that was something that we needed to investigate further.
0:05:11 > 0:05:14As the policy had been taken out with a new temporary phone number
0:05:14 > 0:05:17the customer was using after their phone had been broken,
0:05:17 > 0:05:20it suggested that the policy was also taken out
0:05:20 > 0:05:22after the accident had taken place.
0:05:22 > 0:05:27All this was pointing to a potentially fraudulent claim.
0:05:27 > 0:05:28If you're taking out a policy,
0:05:28 > 0:05:31you would expect to take out a policy with the telephone number,
0:05:31 > 0:05:34the contact number of the mobile phone that you're
0:05:34 > 0:05:36actually taking the policy out for.
0:05:36 > 0:05:38And yet, when we went back to check the details
0:05:38 > 0:05:40on this particular customer,
0:05:40 > 0:05:43the inception details they provided when they took out,
0:05:43 > 0:05:47as the contact number, was the new temporary number that they provided.
0:05:47 > 0:05:50With this discrepancy raising a serious question
0:05:50 > 0:05:52about the validity of the claim, a member of Simon's team
0:05:52 > 0:05:55called the claimant to find out whether the phone
0:05:55 > 0:05:59had been damaged before or after the policy had been taken out.
0:05:59 > 0:06:00When questioned in terms of,
0:06:00 > 0:06:03"Why would you provide a temporary number
0:06:03 > 0:06:04"when you're actually taking out a policy,
0:06:04 > 0:06:06"as opposed to your permanent number?",
0:06:06 > 0:06:09the customer could not answer that. And when we pushed further,
0:06:09 > 0:06:13the customer actually admitted that they had taken the policy out
0:06:13 > 0:06:16after the incident actually happened.
0:06:16 > 0:06:20Based on that, we declined the claim and we cancelled the policy.
0:06:20 > 0:06:23The claimant's attempts to take his insurers for a ride...
0:06:25 > 0:06:27..had backfired badly.
0:06:27 > 0:06:32This appeared to be a customer that had made an opportunist-type claim,
0:06:32 > 0:06:34you know, an incident potentially had happened but they didn't have a
0:06:34 > 0:06:36policy in force.
0:06:36 > 0:06:39Now, on this occasion, we declined the claim
0:06:39 > 0:06:42and we cancelled the policy but quite clearly,
0:06:42 > 0:06:45with this type of thing, they can be taken further and indeed
0:06:45 > 0:06:48we could have taken criminal proceedings on this type of case.
0:06:54 > 0:06:59At least one person can see right through a man's blatant attempt
0:06:59 > 0:07:00to cash in...
0:07:00 > 0:07:02The pub manager was very surprised.
0:07:02 > 0:07:06In fact, his words were, he felt that he was "trying it on".
0:07:06 > 0:07:10And a clairvoyant claiming to magically predict her own accident.
0:07:11 > 0:07:14She was allegedly heard to say to another colleague,
0:07:14 > 0:07:18that there was a claim to be made here if someone tripped over this.
0:07:23 > 0:07:28Every year, around 186,000 people are injured on Britain's roads,
0:07:28 > 0:07:30from minor cases of whiplash to broken bones
0:07:30 > 0:07:33and life-threatening injuries.
0:07:33 > 0:07:36The possibility of an accident being caused deliberately
0:07:36 > 0:07:39in order to claim compensation money from insurance companies
0:07:39 > 0:07:41is almost unthinkable, but sadly,
0:07:41 > 0:07:45it's a problem that's becoming all too common for insurers.
0:07:49 > 0:07:52In order to fight these fraudulent claims,
0:07:52 > 0:07:55insurance companies are working closely with legal firms
0:07:55 > 0:07:59and the police to try and combat the problem together.
0:08:01 > 0:08:03Back in 2016,
0:08:03 > 0:08:06law firm Keoghs work with insurers Axa to get to the bottom
0:08:06 > 0:08:09of a motor insurance claim from a couple involved
0:08:09 > 0:08:12in a rear-end collision on a visit to London.
0:08:12 > 0:08:14It was in the north of London on a dual carriageway,
0:08:14 > 0:08:18the Watford Way. It was the middle of the day, about one o'clock.
0:08:18 > 0:08:21The insured driver had just been doing his normal daily duties,
0:08:21 > 0:08:25carrying out deliveries, and he was on his way to his next delivery.
0:08:25 > 0:08:27As he was driving along the dual carriageway,
0:08:27 > 0:08:29not the car in front of him,
0:08:29 > 0:08:31but the one in front of that, suddenly veered across,
0:08:31 > 0:08:33causing the car in front of him to slam its brakes on.
0:08:33 > 0:08:35And despite trying to stop,
0:08:35 > 0:08:37the insured driver was unable to stop going into the back
0:08:37 > 0:08:39of the claimant's vehicle.
0:08:40 > 0:08:43The driver of the car in front claimed for vehicle damage,
0:08:43 > 0:08:46the recovery and storage of his car,
0:08:46 > 0:08:49the hire cost of a replacement vehicle and personal injuries.
0:08:51 > 0:08:53The two passengers, his wife and a friend,
0:08:53 > 0:08:56claimed for injury and subsequent physiotherapy treatment.
0:08:57 > 0:09:02The driver's claim, that was just over £20,000 in itself,
0:09:02 > 0:09:04and the two injury claims were probably worth
0:09:04 > 0:09:06over £5,000 between them.
0:09:06 > 0:09:09In total for the damages, just over £25,000.
0:09:09 > 0:09:11Then, of course, there were the lawyers' costs on top of that.
0:09:11 > 0:09:13They were probably about the same again,
0:09:13 > 0:09:16so Axa's exposure in terms of the total of the third-party claims
0:09:16 > 0:09:18was about £50,000.
0:09:18 > 0:09:21Axa looked at the claims themselves to validate the legitimacy of them,
0:09:21 > 0:09:24and in parallel to that, the insured raised their concerns,
0:09:24 > 0:09:26and it was those combinations of factors
0:09:26 > 0:09:30that caused this to be a claim that was scrutinised in more detail.
0:09:30 > 0:09:33It was a pretty big bill for the insurance company to foot,
0:09:33 > 0:09:36so before paying out, they decided to look into the claim
0:09:36 > 0:09:38in more detail.
0:09:38 > 0:09:41Luckily, the delivery van that had crashed into the rear
0:09:41 > 0:09:45of the Mercedes was fitted with a dashboard camera,
0:09:45 > 0:09:49and investigators were able to view the footage from the crash.
0:09:49 > 0:09:51As the parties are proceeding along the dual carriageway,
0:09:51 > 0:09:54there's a service station to the left-hand side
0:09:54 > 0:09:56which is linked to a retail park.
0:09:56 > 0:10:00At first, it appears as though the Mercedes and the car in front of it
0:10:00 > 0:10:02are going to go straight past that service station.
0:10:02 > 0:10:04Then at the very last moment,
0:10:04 > 0:10:10the third car swerves violently into the service station and that causes
0:10:10 > 0:10:13the claimant to absolutely slam his brakes on,
0:10:13 > 0:10:16and that goes into the back of the Mercedes at quite a forceful collision.
0:10:16 > 0:10:20It looks like your everyday rear-end collision,
0:10:20 > 0:10:22but when investigators rewound the video
0:10:22 > 0:10:24to look at the build-up to the incident,
0:10:24 > 0:10:28they noticed something rather suspicious.
0:10:28 > 0:10:30About a minute before the impact,
0:10:30 > 0:10:33the dash cam shows the van approaching a junction.
0:10:33 > 0:10:36You can clearly see the Mercedes and the third party car
0:10:36 > 0:10:40in the middle lane as the traffic begins to slow.
0:10:40 > 0:10:43And it's very clear there's a distinct movement by the claimant
0:10:43 > 0:10:45and the blue car, the unidentified blue car.
0:10:45 > 0:10:49They both switch lanes for no apparent reason, and to me,
0:10:49 > 0:10:52that was the point at which they had targeted the insured.
0:10:52 > 0:10:55It looked like the two vehicles were working together
0:10:55 > 0:10:58to stage an accident, something which insurance fraud investigators
0:10:58 > 0:11:01see time and time again.
0:11:01 > 0:11:03The claimants will always contend that it was a vehicle they'd
0:11:03 > 0:11:06never seen. They had no connection to it.
0:11:06 > 0:11:08We will always, of course, try and prove the contrary,
0:11:08 > 0:11:11try and link them, cos if we can link those two vehicles,
0:11:11 > 0:11:14the people in those vehicles,
0:11:14 > 0:11:17then clearly, we can show that it's part of a joint enterprise.
0:11:17 > 0:11:21Unfortunately, in this instance, we weren't able to do that.
0:11:21 > 0:11:26Although the cab cam footage is very clear in terms of the Mercedes,
0:11:26 > 0:11:30we weren't able to identify the registration mark from the blue car.
0:11:31 > 0:11:32With that avenue closed,
0:11:32 > 0:11:35the next step is to look at the backgrounds of the claimants
0:11:35 > 0:11:39to see if they had any previous dealings with insurance fraud.
0:11:39 > 0:11:42One of the passengers, it was uncovered that he had
0:11:42 > 0:11:44a previous history of involvement in credit card fraud.
0:11:44 > 0:11:47He had got a conviction for that some years previously.
0:11:47 > 0:11:50That kind of raised the question of the sort of individuals that we were dealing with.
0:11:50 > 0:11:53With the case for fraud looking strong,
0:11:53 > 0:11:55Axa decided to reject the claims.
0:11:57 > 0:12:01But the driver and his wife refused to accept the rejection,
0:12:01 > 0:12:04so court proceedings were issued against them.
0:12:07 > 0:12:10At court, the couple were questioned separately
0:12:10 > 0:12:13and asked for their version of events on the day.
0:12:13 > 0:12:16They suggested that they were travelling to London
0:12:16 > 0:12:21to see the sick child of a friend of the third claimant.
0:12:21 > 0:12:23but neither of them knew anything about that individual.
0:12:23 > 0:12:26We therefore probed around the third claimant himself.
0:12:26 > 0:12:30The husband said he was just a friend of a friend, an association,
0:12:30 > 0:12:32not very tightly connected to them.
0:12:32 > 0:12:34They were just doing him a favour.
0:12:34 > 0:12:38The wife said that it was a family member that used to live with them.
0:12:38 > 0:12:42You'd think you'd be able to tell the difference between a friend
0:12:42 > 0:12:44and a family member.
0:12:44 > 0:12:46In terms of the person they were visiting,
0:12:46 > 0:12:49neither of them knew really who it was.
0:12:49 > 0:12:53They could only say that it was Elvis from Enfield,
0:12:53 > 0:12:55a friend of the third claimant.
0:12:55 > 0:12:58They didn't know where he lived. They didn't know his full name.
0:12:58 > 0:13:00They only knew him as Elvis.
0:13:00 > 0:13:03They didn't know which hospital they'd allegedly just been to.
0:13:03 > 0:13:05They didn't know the name of the child.
0:13:05 > 0:13:06They didn't know what was wrong,
0:13:06 > 0:13:09why the child was poorly and in hospital.
0:13:09 > 0:13:12It seems like this couple had failed to conjure up
0:13:12 > 0:13:14even the most basic of stories.
0:13:14 > 0:13:18Perhaps they could do better when it came to their injury claim.
0:13:18 > 0:13:21In the witness box, they said that the only injuries they'd sustained
0:13:21 > 0:13:24was a minor injury to the neck and lower back, a whiplash type injury.
0:13:24 > 0:13:27Yet when presented with the written medical report served earlier
0:13:27 > 0:13:29in the court proceedings,
0:13:29 > 0:13:32that had listed whole variety of additional injuries
0:13:32 > 0:13:35to their arms, legs, all sorts of things that they said had occurred
0:13:35 > 0:13:37as a result of the collision.
0:13:37 > 0:13:39When we put those inconsistencies to them,
0:13:39 > 0:13:43they tried very clearly to distance themselves from the medical reports.
0:13:43 > 0:13:46They just said that the medical reports were wrong.
0:13:46 > 0:13:49It now appeared that they couldn't even remember the injuries
0:13:49 > 0:13:53that they'd reported during their medical examination.
0:13:53 > 0:13:56One of the most expensive parts of the claim was for the recovery
0:13:56 > 0:13:58of the damaged car.
0:13:58 > 0:14:01The husband and wife both said they had rung a claims management company
0:14:01 > 0:14:06to recover the vehicle, but that's as far as their stories tallied.
0:14:06 > 0:14:09The husband said that the claims management company came out
0:14:09 > 0:14:12to the service station and recovered his car from there and took it away.
0:14:12 > 0:14:15He said that they had to stay at the service station
0:14:15 > 0:14:18until they rang a friend that travelled from Birmingham
0:14:18 > 0:14:21to pick them up, and that they travelled from the service station
0:14:21 > 0:14:22straight back home.
0:14:22 > 0:14:25The wife's version was completely different.
0:14:25 > 0:14:28She said that the claims management company came to the scene
0:14:28 > 0:14:30and took them from there to their offices
0:14:30 > 0:14:33where her husband completed a whole host of paperwork
0:14:33 > 0:14:36and that they'd stayed at the offices until the friend
0:14:36 > 0:14:38had come from Birmingham to take them home.
0:14:38 > 0:14:41Just totally different versions that couldn't be reconciled.
0:14:42 > 0:14:45Just when the insurers thought this case
0:14:45 > 0:14:46couldn't get any more ridiculous,
0:14:46 > 0:14:49one final piece of evidence came to light
0:14:49 > 0:14:51regarding the couple's children.
0:14:51 > 0:14:53The expectation had been
0:14:53 > 0:14:55that following an incident of this nature,
0:14:55 > 0:14:59she would have instantly been in contact with the aunt
0:14:59 > 0:15:02that she said was looking after her children.
0:15:02 > 0:15:05But she made no comment on that. She said that she didn't make contact.
0:15:05 > 0:15:06She didn't attempt to make contact.
0:15:06 > 0:15:09And that was despite one of her youngest children
0:15:09 > 0:15:11being aged less than one. A baby.
0:15:11 > 0:15:13To us, it spoke volumes.
0:15:13 > 0:15:16They didn't contact the aunt, the carer,
0:15:16 > 0:15:19because they knew they were always going to be back late.
0:15:19 > 0:15:21That had been the arrangements in place,
0:15:21 > 0:15:24because this was a pre-planned, pre-prepared event.
0:15:24 > 0:15:27So to recap, the couple couldn't decide
0:15:27 > 0:15:29if their passenger was a friend or family member.
0:15:29 > 0:15:32They didn't know where the friend they were visiting lived
0:15:32 > 0:15:34or what was wrong with his child.
0:15:34 > 0:15:37Their stories didn't match on which route they'd taken home
0:15:37 > 0:15:41after the accident and they didn't even contact their children's carer
0:15:41 > 0:15:44to let her know if they'd been involved in a crash.
0:15:46 > 0:15:47Got it.
0:15:47 > 0:15:50Having heard all of the evidence, the judge was entirely satisfied
0:15:50 > 0:15:52that this was a fraudulent claim.
0:15:52 > 0:15:55That it was a pre-planned event and that these were claimants
0:15:55 > 0:15:58who had deliberately set out that day to induce an accident.
0:15:58 > 0:16:02The judge found the couple to have been fundamentally dishonest
0:16:02 > 0:16:04and threw the case out of court.
0:16:04 > 0:16:08It was a very positive outcome, both for Axa and for their policyholder.
0:16:08 > 0:16:10The claimants received nothing.
0:16:10 > 0:16:14But in addition, Axa had paid out for damage to their insured's
0:16:14 > 0:16:17vehicle and we counterclaimed for that.
0:16:17 > 0:16:20We put in a claim to say that because this was a fraudulent claim
0:16:20 > 0:16:24and because the accident wasn't the fault of the insured driver,
0:16:24 > 0:16:27we should be reimbursed the sum in terms of that vehicle damage,
0:16:27 > 0:16:29and we were awarded those sums.
0:16:29 > 0:16:31The case was closed, but for James,
0:16:31 > 0:16:34the fight against fraud is a never-ending battle.
0:16:34 > 0:16:38It's vital that insurers and their partners tackle
0:16:38 > 0:16:40fraud of this nature. It's insidious,
0:16:40 > 0:16:42it's targeting innocent members of the public,
0:16:42 > 0:16:46and this is a real classic example of an engaged customer
0:16:46 > 0:16:49who felt they were the victim and that they were supported
0:16:49 > 0:16:52by their insurers, and this is exactly the sort of case
0:16:52 > 0:16:55that insurers can fight,
0:16:55 > 0:16:58do fight and are becoming ever more successful in fighting.
0:17:03 > 0:17:05Now, when we go to work,
0:17:05 > 0:17:08it's our employers' responsibility to provide a safe environment.
0:17:08 > 0:17:09So, if we have an accident,
0:17:09 > 0:17:13the chances are we're covered by their insurance policy.
0:17:13 > 0:17:15With this in mind,
0:17:15 > 0:17:17fraudsters have been known to go to great lengths
0:17:17 > 0:17:21to stage fake accidents, in the hope of receiving compensation.
0:17:21 > 0:17:24But what many of these opportunists don't realise
0:17:24 > 0:17:27is that insurance companies have a wealth of techniques
0:17:27 > 0:17:31they can employ to determine whether a claim is genuine or not.
0:17:33 > 0:17:36In addition to providing car and home insurance policies,
0:17:36 > 0:17:40Allianz also insure a range of businesses.
0:17:43 > 0:17:46Mark Merrix is the fraud manager there, and knows the importance
0:17:46 > 0:17:49of validating each claim that comes in.
0:17:49 > 0:17:52He recently received a claim from a woman injured in a shop.
0:17:54 > 0:17:58The claimant was the manager of the stationery store,
0:17:58 > 0:18:02and it was alleged that, whilst carrying a box
0:18:02 > 0:18:05which weighed about 22kg,
0:18:05 > 0:18:07she tripped over a wire.
0:18:07 > 0:18:11This allegedly caused her to tumble down two steps,
0:18:11 > 0:18:15which caused her to sustain injuries to her shoulder, ribs,
0:18:15 > 0:18:18her left elbow and her left knee.
0:18:18 > 0:18:21It appeared to be a genuine workplace accident,
0:18:21 > 0:18:25unfortunately resulting in minor injuries.
0:18:25 > 0:18:29She consulted her GP the day after the accident,
0:18:29 > 0:18:32and the GP said she needed to take three weeks off work
0:18:32 > 0:18:34to recover from her symptoms.
0:18:34 > 0:18:36To support her claim,
0:18:36 > 0:18:40her lawyers instructed a medical expert for an opinion.
0:18:40 > 0:18:42Based upon the opinion of the expert,
0:18:42 > 0:18:46the claimant was expecting to recover fully from her injuries
0:18:46 > 0:18:48within six weeks of the accident.
0:18:48 > 0:18:50Although these weren't serious injuries,
0:18:50 > 0:18:54the woman was set to receive around £1,500 in compensation.
0:18:57 > 0:19:00When an insurance company receives a claim,
0:19:00 > 0:19:03it carries out a basic checks to ensure the claim is genuine.
0:19:03 > 0:19:06But when Allianz began their enquiries,
0:19:06 > 0:19:09they stumbled across a surprising piece of information.
0:19:10 > 0:19:14Our initial validation checks established that four years prior
0:19:14 > 0:19:18to this accident, she had in fact intimated a claim
0:19:18 > 0:19:20against her local county council
0:19:20 > 0:19:23for a tripping incident,
0:19:23 > 0:19:26where she sustained a personal injury.
0:19:26 > 0:19:28Upon further investigation with their insurers,
0:19:28 > 0:19:31we soon established that when challenged,
0:19:31 > 0:19:33the claim was promptly withdrawn.
0:19:33 > 0:19:37This raised some serious concerns for our handler,
0:19:37 > 0:19:39and therefore as a result,
0:19:39 > 0:19:43we decided to pursue further investigations into this case.
0:19:43 > 0:19:46Allianz turned to the woman's colleagues to see if they could
0:19:46 > 0:19:48back up her story.
0:19:48 > 0:19:51The witness evidence that Allianz obtained
0:19:51 > 0:19:54from the claimant's own colleagues supported the fact
0:19:54 > 0:19:58that she'd identified this potential tripping hazard
0:19:58 > 0:20:03some four hours before the actual accident took place.
0:20:03 > 0:20:06She was allegedly heard to say to another colleague
0:20:06 > 0:20:10that there was a claim to be made here if someone tripped over this.
0:20:11 > 0:20:14Combined with the discovery of her previous tripping claim that had
0:20:14 > 0:20:18been withdrawn as soon as it was challenged, the witness evidence
0:20:18 > 0:20:21from this latest claim raised serious concerns.
0:20:24 > 0:20:28Allianz then received digital photos of the wire that she had allegedly
0:20:28 > 0:20:32tripped over and were able to analyse the data behind the photos
0:20:32 > 0:20:36to see the dates and time at which they were taken.
0:20:36 > 0:20:38Using this information,
0:20:38 > 0:20:44we were able to support the witness evidence that indicated that these
0:20:44 > 0:20:48photos were taken four hours prior to the accident taking place.
0:20:48 > 0:20:52With the evidence in their favour, Allianz turned to their solicitors,
0:20:52 > 0:20:55DAC Beachcroft, to investigate the claim further.
0:20:57 > 0:20:59We asked the claimant to formally
0:20:59 > 0:21:03say when she had taken the photographs.
0:21:03 > 0:21:06We asked her to reply with a signed statement of truth,
0:21:06 > 0:21:10which means that she has to sign that piece of paper and say that she
0:21:10 > 0:21:13honestly believes that that is true. Having done that,
0:21:13 > 0:21:17we were then in a position to disclose a photograph
0:21:17 > 0:21:20with a description of when they had been taken.
0:21:20 > 0:21:25At that point, the claimant' stated timing was clearly at odds
0:21:25 > 0:21:27with the evidence that we had produced.
0:21:29 > 0:21:32With the woman clearly lying about the time she'd taken
0:21:32 > 0:21:36the photographs, there was only one conclusion.
0:21:36 > 0:21:40DAC Beachcroft and Allianz decided together that we would then plead
0:21:40 > 0:21:44that the claim was fraudulent and it was at that point that the claimant
0:21:44 > 0:21:47got cold feet and tried to withdraw from the claim.
0:21:47 > 0:21:50The fact that the claimant wanted to withdraw her claim clearly showed
0:21:50 > 0:21:54that she'd been rumbled. She knew that we then had the evidence
0:21:54 > 0:21:57that we could use against her and she knew that she was in danger
0:21:57 > 0:22:00of a finding of fundamental dishonesty or fraud.
0:22:02 > 0:22:05If any part of the claim was found to be fundamentally dishonest,
0:22:05 > 0:22:10then the judge would be able to throw the entire case out of court.
0:22:10 > 0:22:14At the hearing, the judge found the claim to be fundamentally dishonest,
0:22:14 > 0:22:18as a result of which the claimant was ordered to pay Allianz's costs
0:22:18 > 0:22:21just shy of £18,000.
0:22:21 > 0:22:22The claimant took a risk.
0:22:22 > 0:22:26She thought that it was worth having a go and seeing if she could make
0:22:26 > 0:22:29herself some money. It clearly shows that that wasn't worth it,
0:22:29 > 0:22:34because she's ended up with an award against her which is many times the
0:22:34 > 0:22:37value of the original claim.
0:22:37 > 0:22:41The outcome of the case sent a clear message to would-be fraudsters.
0:22:41 > 0:22:46It's really important that people understand that what seems like an
0:22:46 > 0:22:51opportunity and what seems like an easy win really isn't an easy win.
0:22:51 > 0:22:55We need fraudsters to understand that they will have to pay for their
0:22:55 > 0:22:59action and so, if they make that claim, having seen an opportunity,
0:22:59 > 0:23:01there will be consequences.
0:23:07 > 0:23:09Now, as we demonstrate on this programme,
0:23:09 > 0:23:13fraudulent insurance claims take many different forms,
0:23:13 > 0:23:17from deliberate slips and trips to staged car accidents to exaggerated
0:23:17 > 0:23:21travel insurance claims and even bogus bus crush injuries.
0:23:21 > 0:23:25We've seen them all. It's all fraud and it's all illegal.
0:23:25 > 0:23:29But what if what's being claimed for never even happened?
0:23:29 > 0:23:31Yeah, you guessed it, same story.
0:23:33 > 0:23:35In the case of an accident,
0:23:35 > 0:23:38you never know when disaster might strike.
0:23:38 > 0:23:40But depending on the circumstances,
0:23:40 > 0:23:44it's possible that you could be entitled to compensation for your injuries.
0:23:45 > 0:23:49Pub chain JD Wetherspoon recently dealt with a claim from a cyclist
0:23:49 > 0:23:53that brought a whole new meaning to the saying "one for the road."
0:23:55 > 0:23:58We received a claim for compensation from a member of the public who says
0:23:58 > 0:24:03that they were injured following an accident at one of our pubs.
0:24:03 > 0:24:06With thousands of customers passing through the doors of their pubs
0:24:06 > 0:24:11every day, the occasional injury is inevitable.
0:24:11 > 0:24:15However, the circumstances of this one stuck out a little bit.
0:24:15 > 0:24:19The claimant said that while he was riding his bicycle along the
0:24:19 > 0:24:21perimeter fence of our beer garden,
0:24:21 > 0:24:25there was a metal bar sticking out of the fence and he rode over that
0:24:25 > 0:24:30metal bar, fell off his bike and that he sustained some broken ribs
0:24:30 > 0:24:32and cuts and bruises.
0:24:33 > 0:24:37Never mind a tipple, this poor chap was claiming he had had a massive
0:24:37 > 0:24:42topple and it sounded as though it was a very painful landing.
0:24:42 > 0:24:47But to the trained eye, immediately something wasn't quite right.
0:24:47 > 0:24:49The claim didn't seem legitimate.
0:24:49 > 0:24:53Any time we receive a claim that involves broken bones fractures,
0:24:53 > 0:24:56it automatically puts the claim in a particular value bracket.
0:24:56 > 0:25:00We estimated if there were proven broken bones or fractures,
0:25:00 > 0:25:03we'd be looking well into the thousands of pounds.
0:25:03 > 0:25:07However, the claimant specifically said that he wanted to claim £625
0:25:07 > 0:25:10for ten days off work.
0:25:11 > 0:25:13Ordinarily, with claims for personal injury,
0:25:13 > 0:25:17damages are determined with the help of medical reports and legal advice.
0:25:17 > 0:25:22But this guy knew exactly what he wanted.
0:25:22 > 0:25:26However, to have such a precise amount specified by a claimant that
0:25:26 > 0:25:29was in fact so far off what the claim should have been worth sounded
0:25:29 > 0:25:32more like an opportunistic demand.
0:25:32 > 0:25:35We spoke to the pub manager to find out whether he or other of the
0:25:35 > 0:25:38member of staff had witnessed an accident or had anyone come into the
0:25:38 > 0:25:42pub to say that that they had been injured following an accident.
0:25:42 > 0:25:46The pub manager didn't recall anyone reporting a serious incident,
0:25:46 > 0:25:50except for the claimant who said that there was a metal bar sticking
0:25:50 > 0:25:54out of the fence. When he went to investigate this fence,
0:25:54 > 0:25:57he didn't see any metal bar sticking out.
0:25:57 > 0:26:00More importantly, he didn't see that the claimant showed any signs of
0:26:00 > 0:26:04physical injury or was in any pain at all.
0:26:04 > 0:26:09So far, the pub manager's comments weren't exactly backing up the
0:26:09 > 0:26:11cyclist's version of events.
0:26:11 > 0:26:13The pub manager was very surprised.
0:26:13 > 0:26:17In fact, his words were, he felt that he was "trying it on."
0:26:17 > 0:26:19But we take every claim seriously
0:26:19 > 0:26:22and we investigated it very seriously.
0:26:22 > 0:26:26As verdicts go, the pub manager's was rather damning,
0:26:26 > 0:26:29but there was another source of evidence that Leandro
0:26:29 > 0:26:32was able to call upon - CCTV.
0:26:32 > 0:26:33For customers' safety,
0:26:33 > 0:26:38JD Wetherspoon pubs are fitted with cameras and, as luck would have it,
0:26:38 > 0:26:41the entire "accident" had been caught on film.
0:26:41 > 0:26:44Looking at the CCTV footage, we'd expect to see the claimant
0:26:44 > 0:26:46falling off his bike and hurting himself.
0:26:47 > 0:26:51Just a warning, this doesn't make for easy viewing.
0:26:51 > 0:26:54We can see the claimant riding past the beer garden...
0:26:54 > 0:26:57And the crash is coming...
0:26:57 > 0:27:00- Oh!- He parks his bike up, gets off.
0:27:00 > 0:27:05Here, we can see him attempting to reach through the garden fence.
0:27:05 > 0:27:08But what's really telling is that he's looking around.
0:27:08 > 0:27:12We don't think that he knows he's being filmed but we certainly can
0:27:12 > 0:27:15tell from these actions that he's trying to see whether there's anyone
0:27:15 > 0:27:19around who might see him. He gets back on his bike again,
0:27:19 > 0:27:21he cycles off.
0:27:21 > 0:27:24We can't see any fall at all.
0:27:24 > 0:27:29Exactly what the cyclist was doing was anybody's guess but three things
0:27:29 > 0:27:31were crystal clear -
0:27:31 > 0:27:33he had never fallen off his bike,
0:27:33 > 0:27:37he hadn't injured himself, and he was trying to get his hands on a
0:27:37 > 0:27:39pay-out that he wasn't entitled to.
0:27:39 > 0:27:42When we are investigating personal injury claims,
0:27:42 > 0:27:45and we are investigating what we feel our fraudulent claims,
0:27:45 > 0:27:49CCTV footage is one of the most important pieces of evidence.
0:27:49 > 0:27:54Whereas we might have statements from witnesses or individuals,
0:27:54 > 0:27:57CCTV footage is real time.
0:27:57 > 0:28:00There's no way that you can argue with what video footage
0:28:00 > 0:28:01is showing us.
0:28:01 > 0:28:05Confident the CCTV was the ace up their sleeves,
0:28:05 > 0:28:07Leandro and his team were still keen
0:28:07 > 0:28:10to see whether the cyclist could back up his claim.
0:28:11 > 0:28:16We also asked the claimant to send us evidence of his physical injuries
0:28:16 > 0:28:21and also evidence to prove that he lost earnings due to his time off work.
0:28:21 > 0:28:25The claimant sent us some medical evidence but the medical evidence
0:28:25 > 0:28:27showed no evidence of any broken ribs.
0:28:27 > 0:28:31We never received any evidence of his loss of earnings,
0:28:31 > 0:28:35certainly any evidence to show that he'd lost £625.
0:28:35 > 0:28:39So no proof of broken bones, no proof of loss of earnings.
0:28:39 > 0:28:42Oh, and no accident.
0:28:42 > 0:28:47This claim was sinking faster than a cold pint on a hot day.
0:28:47 > 0:28:51It was clear that this claimant had a lot of questions to answer.
0:28:51 > 0:28:53I contacted the claimant personally by phone.
0:28:53 > 0:28:55We spoke about the alleged accident.
0:28:55 > 0:29:00He was very confident that he was riding his bike along the garden fence,
0:29:00 > 0:29:04that he fell off as a result of a metal bar that was sticking out.
0:29:04 > 0:29:05He said he went to a walk-in centre,
0:29:05 > 0:29:08and he was told that he had broken ribs.
0:29:08 > 0:29:11When I confronted the claimant, however, with the fact the pub
0:29:11 > 0:29:14manager said that there was no damage to the fence,
0:29:14 > 0:29:16he didn't seem to be in any pain,
0:29:16 > 0:29:21we also had CCTV footage that didn't show him falling off his bike,
0:29:21 > 0:29:25the claimant politely ended the conversation and thanked me
0:29:25 > 0:29:27for my time.
0:29:27 > 0:29:31And with that, time was called on this claim.
0:29:31 > 0:29:34But even though the right result had been reached,
0:29:34 > 0:29:38spurious and fictitious claims like these are a constant headache.
0:29:38 > 0:29:42It's very sad, because there are people who have accidents with very
0:29:42 > 0:29:45serious injuries and a lot of the resources that we can use to
0:29:45 > 0:29:49investigate those claims and try to resolve them quickly and efficiently
0:29:49 > 0:29:53are diverted to investigating fraudulent claims and at the end of
0:29:53 > 0:29:56the day, it's those genuine claimants who do suffer.
0:30:03 > 0:30:05Still to come...
0:30:05 > 0:30:09a conniving couple discover the consequences of committing insurance
0:30:09 > 0:30:14- fraud.- Caution will stay on their records for four years, they get
0:30:14 > 0:30:18fingerprinted, they get their mugshots taken, so it's...
0:30:18 > 0:30:21It's a criminal act and they are treated like criminals.
0:30:26 > 0:30:30Insurance companies receive thousands of claims every day,
0:30:30 > 0:30:33resulting in millions of pounds paid out to policyholders.
0:30:33 > 0:30:37Now, to ensure that the claim is genuine, insurers will ask for
0:30:37 > 0:30:39evidence to back up the information they're being
0:30:39 > 0:30:43provided with, but when that evidence looks a bit dodgy,
0:30:43 > 0:30:46it alerts insurers to the possibility that the claim itself
0:30:46 > 0:30:50also isn't as legitimate as it may first appear.
0:30:51 > 0:30:55Some fraudsters think that by carefully forging documents in an
0:30:55 > 0:30:59attempt to prove their claim, they won't be found out.
0:30:59 > 0:31:03But it's often simple mistakes that leave them caught without a leg to
0:31:03 > 0:31:06stand on. Cega, a Charles Taylor company,
0:31:06 > 0:31:10receives hundreds of travel insurance claims on a daily basis.
0:31:10 > 0:31:13They recently dealt with the case where a policyholder was claiming
0:31:13 > 0:31:17compensation for an illness she'd picked up abroad.
0:31:18 > 0:31:22We received the claim for medical treatment from the customer who
0:31:22 > 0:31:25unfortunately got unwell while she was in India.
0:31:27 > 0:31:30The infection was so severe for the woman, it meant a two-day stay
0:31:30 > 0:31:33in hospital with the cost of treatment working out
0:31:33 > 0:31:36to be just over £700.
0:31:37 > 0:31:39When we receive claims like this,
0:31:39 > 0:31:43we do need a certain level of documentation to support the claim,
0:31:43 > 0:31:46such as a medical report and an invoice to show how much was paid
0:31:46 > 0:31:48for the treatment.
0:31:48 > 0:31:51But when the customer provided the receipts for the treatment,
0:31:51 > 0:31:53something didn't seem quite right.
0:31:53 > 0:31:57Firstly, we noted that the customer had paid for the treatment
0:31:57 > 0:32:00in pounds sterling when she was in India,
0:32:00 > 0:32:03so we would expect her to pay in Indian rupees.
0:32:03 > 0:32:07Cega are well versed in dealing with claims where medical treatment has
0:32:07 > 0:32:10been given abroad so they've got a good idea
0:32:10 > 0:32:13of what's legit and what's not.
0:32:13 > 0:32:16And this claim was showing signs of trouble from the start.
0:32:17 > 0:32:22This was a very high amount to have paid for two-day inpatient treatment
0:32:22 > 0:32:26in hospital and we are fully aware of that, due to the nature
0:32:26 > 0:32:29of our business and the amount of medical claims that we
0:32:29 > 0:32:30review from India.
0:32:32 > 0:32:35With the amount the woman was claiming looking unrealistic,
0:32:35 > 0:32:38the company then turned to the medical report she'd given them,
0:32:38 > 0:32:42which didn't exactly look like the real deal either.
0:32:44 > 0:32:48The most alarming thing that we noted from the medical documentation
0:32:48 > 0:32:51that the customer had provided was that there was a glaringly obvious
0:32:51 > 0:32:55spelling mistake, where the doctor had referred to what we believe
0:32:55 > 0:32:58should have been "wheezing" and he had put "whezzing".
0:33:00 > 0:33:03You certainly wouldn't expect a highly skilled doctor to misspell
0:33:03 > 0:33:07the word "wheezing" when he's writing a medical report.
0:33:07 > 0:33:11Yeah, it is clear there was some dodgy dealings going on but Cega
0:33:11 > 0:33:14weren't going to get to the bottom of this case while they were some
0:33:14 > 0:33:175,000 miles away from where it happened.
0:33:18 > 0:33:23As we deal with international claims daily, we have to have this
0:33:23 > 0:33:26international network of overseas investigators who
0:33:26 > 0:33:29can conduct enquiries in any part of the world.
0:33:29 > 0:33:32Due to the concerns with this claim, we decided to appoint one of our
0:33:32 > 0:33:35international investigators to conduct
0:33:35 > 0:33:39on-the-ground enquiries in India to validate the claim.
0:33:39 > 0:33:41They started by checking out the doctor's details
0:33:41 > 0:33:44on the medical report.
0:33:44 > 0:33:46The first thing our investigator did
0:33:46 > 0:33:49was check with the Indian Medical Council to see whether the doctor
0:33:49 > 0:33:52was licensed to practise medicine.
0:33:52 > 0:33:55Unfortunately, there was no trace of the doctor, which just aroused
0:33:55 > 0:33:57our suspicion further.
0:33:57 > 0:34:00As the doctor's name wasn't on the list,
0:34:00 > 0:34:04it meant he wasn't legally allowed to practise medicine in India,
0:34:04 > 0:34:07rendering the medical report next to useless.
0:34:08 > 0:34:12Perhaps the investigator would have more luck with the hospital the
0:34:12 > 0:34:14woman claimed to have been treated at.
0:34:17 > 0:34:20We had previously been told by the customer that the hospital provided
0:34:20 > 0:34:25catering facilities and that she had also had x-rays, so we were very
0:34:25 > 0:34:28surprised to hear from the hospital that they don't have catering
0:34:28 > 0:34:32facilities and they also don't even own an X-ray machine.
0:34:32 > 0:34:35With the claim looking dodgier by the day,
0:34:35 > 0:34:39the final port of call was to look at the customer's hospital records.
0:34:40 > 0:34:44Our investigator visited the hospital and spoke with the hospital staff
0:34:44 > 0:34:47who checked their official records, and to our astonishment,
0:34:47 > 0:34:50the customer wasn't listed anywhere as being an inpatient
0:34:50 > 0:34:55within the hospital. In fact, she wasn't in the records at all.
0:34:55 > 0:34:58The case was clear-cut.
0:34:58 > 0:35:01The woman had never even visited the hospital.
0:35:01 > 0:35:04She hadn't received any medical treatment and all the documents
0:35:04 > 0:35:06she'd provided had been false.
0:35:08 > 0:35:11A member of Simon's team then spoke to the customer and she eventually
0:35:11 > 0:35:14admitted she'd made the whole thing up.
0:35:14 > 0:35:18Based on all the evidence that we had obtained in this investigation,
0:35:18 > 0:35:22we had no option but to formally repudiate the claim and invoke the
0:35:22 > 0:35:26fraud condition set out in the policy.
0:35:26 > 0:35:30So no need to cough up any compensation money this time
0:35:30 > 0:35:33and they never heard from the customer again.
0:35:35 > 0:35:38Maybe next time this woman will think more carefully about trying to
0:35:38 > 0:35:41claim for false treatment while abroad.
0:35:41 > 0:35:46The outcome of this investigation demonstrates to people who feel they
0:35:46 > 0:35:49need to make a fraudulent claim that it doesn't actually matter where in
0:35:49 > 0:35:52the world you are, we will unearth the fraud.
0:35:59 > 0:36:03Now, I'm sure every motorist would agree that being hit by another car
0:36:03 > 0:36:06is one of the most infuriating aspects of driving,
0:36:06 > 0:36:10but even more so when instead of stopping, the other driver keeps on
0:36:10 > 0:36:14going and flees the scene. Thankfully, in situations like this,
0:36:14 > 0:36:16car insurance policies have got us covered.
0:36:16 > 0:36:20The money we receive is intended to pay for repairs,
0:36:20 > 0:36:24but a hefty pay-out can make some people very greedy indeed.
0:36:27 > 0:36:31While many of us hope to never claim on our car insurance,
0:36:31 > 0:36:34there are some people out there who view these policies as an easy way
0:36:34 > 0:36:39to make money that they can profit from time and time again.
0:36:39 > 0:36:43Someone who knows only too well about these dodgy dealings
0:36:43 > 0:36:46is Susan Evans at insurance company Admiral.
0:36:46 > 0:36:51In June 2014, we get a report of an accident.
0:36:51 > 0:36:54We had our policyholder on the phone saying that the BMW had been parked
0:36:54 > 0:36:59up and a neighbour had reported that somebody had driven into it.
0:37:01 > 0:37:04Thankfully, they'd got their registration number and they wanted
0:37:04 > 0:37:09to make a claim for the damage that had been occasioned to the BMW.
0:37:10 > 0:37:14It seems like a straightforward claim and during the initial phone call,
0:37:14 > 0:37:18the claims handler was keen to get to the bottom of exactly what had happened.
0:37:50 > 0:37:53The value of the claim that came in was about £5,200,
0:37:53 > 0:37:56so quite a bit of damage had been occasioned to the car.
0:37:57 > 0:38:00As with any claim, the insurance company needed to validate
0:38:00 > 0:38:02the information they received
0:38:02 > 0:38:05but when they looked up the policyholder's records,
0:38:05 > 0:38:08they found a surprising result.
0:38:08 > 0:38:10So, this particular case,
0:38:10 > 0:38:14we had to look and we could see that there had been an earlier claim on
0:38:14 > 0:38:18the same vehicle for very, very similar damage.
0:38:18 > 0:38:21The car was hit whilst parked and unattended.
0:38:24 > 0:38:27With the new claims sounding suspiciously like deja vu,
0:38:27 > 0:38:30Admiral handed the case over to their fraud team,
0:38:30 > 0:38:33who looked up the third-party's registration number to determine
0:38:33 > 0:38:36who they were insured with.
0:38:36 > 0:38:39As luck would have it, on this particular occasion,
0:38:39 > 0:38:40the third party vehicle,
0:38:40 > 0:38:44so the vehicle that was alleged to have caused the damage,
0:38:44 > 0:38:46was also insured with Admiral,
0:38:46 > 0:38:51so we had a direct way to contact the other party that was involved,
0:38:51 > 0:38:54because he was also one of our policyholders.
0:38:54 > 0:38:55They rang the other customer
0:38:55 > 0:38:58and arranged to inspect the alleged damage to his car.
0:38:58 > 0:39:03He was very obliging, allowed us to examine his vehicle and from the
0:39:03 > 0:39:05forensic inspection that we
0:39:05 > 0:39:09made to that car, we could see that the car had never ever come into
0:39:09 > 0:39:12contact with the other vehicle.
0:39:12 > 0:39:16So we measured the distance of the damage from the floor,
0:39:16 > 0:39:19the heights of the vehicles, and it was quite clear that
0:39:19 > 0:39:23that car had not caused the damage to the BMW.
0:39:23 > 0:39:25With alarm bells ringing,
0:39:25 > 0:39:29they decided to pay a visit to the claimant himself.
0:39:29 > 0:39:34Whilst there, the policy holder confirmed that the original damage
0:39:34 > 0:39:39in the original accident in 2011 had never been repaired.
0:39:39 > 0:39:42But he'd driven round in the car in its damaged state since then and
0:39:42 > 0:39:45he'd decided to make another claim
0:39:45 > 0:39:48for exactly the same damage against his insurers.
0:39:48 > 0:39:52The truth had finally come out in a confession from the couple.
0:39:52 > 0:39:55The whole story about their neighbour witnessing another
0:39:55 > 0:39:59motorist hitting their car whilst doing a U-turn and driving off
0:39:59 > 0:40:01was entirely made up.
0:40:01 > 0:40:04It was all so they could attempt to claim again for the damage they'd
0:40:04 > 0:40:08already been compensated for but had never bothered to repair.
0:40:08 > 0:40:12Understandably, Admiral were not impressed.
0:40:12 > 0:40:16On the basis of that evidence, there was no claim for us to pay.
0:40:16 > 0:40:20We repudiated it as the evidence was so strong that the vehicles had
0:40:20 > 0:40:23never come into contact with one another and the damage had never
0:40:23 > 0:40:27been repaired from the original accident in 2011.
0:40:27 > 0:40:30Claim was closed, system was closed down and we didn't think that we
0:40:30 > 0:40:34were going to hear from the individuals again.
0:40:34 > 0:40:38But just when they thought it was game over for these chancers,
0:40:38 > 0:40:42a year and a half later, they tried their luck again.
0:40:42 > 0:40:45And lo and behold, in January 2016,
0:40:45 > 0:40:48we get a phone call from the policyholder,
0:40:48 > 0:40:52saying he wants to repair his vehicle, the same damage as we've
0:40:52 > 0:40:56already said we're not going to be dealing with.
0:41:39 > 0:41:42Unbelievably, the customers were trying to claim for the damage
0:41:42 > 0:41:45a third time, despite already receiving a pay-out
0:41:45 > 0:41:47for the first claim.
0:41:47 > 0:41:50Suffice to say, this needed to be stopped,
0:41:50 > 0:41:53so Admiral reported their findings to the City of London Police's
0:41:53 > 0:41:56insurance fraud enforcement department, who,
0:41:56 > 0:41:58after arresting and interviewing the couple,
0:41:58 > 0:42:00issued them with a police caution.
0:42:00 > 0:42:03They subsequently arrested the two individuals and they were
0:42:03 > 0:42:09cautioned. And the caution will stay on their records for four years.
0:42:09 > 0:42:12They get fingerprinted, the get their mugshots taken,
0:42:12 > 0:42:16so it's a criminal act and they are treated like criminals.
0:42:18 > 0:42:21It goes to show that when it comes to insurance fraud,
0:42:21 > 0:42:23persistence doesn't pay off.
0:42:23 > 0:42:27I don't think the policyholders realised the gravity of what they
0:42:27 > 0:42:30were doing or indeed the consequences,
0:42:30 > 0:42:35and the punishments that come as a result of committing insurance fraud
0:42:35 > 0:42:38and the general public needs reminding that it is a crime and
0:42:38 > 0:42:42there are punishments that fit that crime.
0:42:47 > 0:42:50Whether it's exaggerating real injuries, totally making up a story
0:42:50 > 0:42:53for a dodgy claim, or masterminding insurance fraud
0:42:53 > 0:42:55on an industrial scale,
0:42:55 > 0:42:58the law is coming down hard on the people who think they can make
0:42:58 > 0:43:02a quick buck with their insurance scams and cons. But the fraudsters
0:43:02 > 0:43:05need to think again, as more of them than ever before
0:43:05 > 0:43:09are being caught in the act and claimed and shamed.