Episode 4

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0:00:02 > 0:00:03TYRES SCREECH

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 > 0:00:44That's the subject out the vehicle.

0:00:44 > 0:00:46..sophisticated data analysis techniques...

0:00:46 > 0:00:47TYRES SCREECH

0:00:47 > 0:00:49Police!

0:00:49 > 0:00:51..and a number of highly skilled police units...

0:00:51 > 0:00:53Police! Don't move, stay where you are!

0:00:53 > 0:00:55.. they're catching the criminals red-handed.

0:00:55 > 0:00:56Just don't lie to us.

0:00:58 > 0:00:59All those conmen,

0:00:59 > 0:01:02scammers and cheats on the fiddle are now caught in the act

0:01:02 > 0:01:04and Claimed and Shamed.

0:01:12 > 0:01:15A chancer is caught out when his fake documents don't fool the

0:01:15 > 0:01:17insurance company.

0:01:25 > 0:01:29Phone records prove pivotal when a man's stories simply don't tally.

0:01:31 > 0:01:35There was no evidence of any calls being made to a recovery garage...

0:01:37 > 0:01:39..on the evening of the alleged breakdown.

0:01:40 > 0:01:44And a bogus car crash story is rumbled when investigators turn to

0:01:44 > 0:01:46CCTV footage.

0:01:46 > 0:01:51At no time could we visually see the Fiesta or the

0:01:51 > 0:01:55Vauxhall Vectra ever entering the bowling alley's car park.

0:02:00 > 0:02:04Before going abroad, it's a good idea to take out travel insurance.

0:02:04 > 0:02:08It can be a life-saver if your flight is cancelled, you lose your

0:02:08 > 0:02:10wallet, or you need urgent medical attention.

0:02:10 > 0:02:14But insurance can be used incorrectly.

0:02:14 > 0:02:15Miles away from home,

0:02:15 > 0:02:18some con artists think they can get away with scamming their insurance

0:02:18 > 0:02:24company, believing their fraudulent claims are less likely to be scrutinised.

0:02:24 > 0:02:26That couldn't be further from the truth.

0:02:29 > 0:02:32While for most of us travel insurance is one of those things

0:02:32 > 0:02:35that we take out hoping that we won't ever need to use,

0:02:35 > 0:02:40there are some people out there who view these policies as a cash cow

0:02:40 > 0:02:43that they can milk again, and again, and again.

0:02:46 > 0:02:51Someone who knows all too well about this kind of unscrupulous behaviour

0:02:51 > 0:02:54is Simon Powell at insurance company Endsleigh.

0:02:56 > 0:02:57Back in 2014,

0:02:57 > 0:03:00they received a claim from a customer who said he'd been the

0:03:00 > 0:03:02victim of a crime while on holiday.

0:03:05 > 0:03:10It was for a bag that was stolen on a tuk-tuk,

0:03:10 > 0:03:12and it consisted of a laptop,

0:03:12 > 0:03:15various different clothing items and toiletries,

0:03:15 > 0:03:17which amounted to £1,600.

0:03:19 > 0:03:22Possibly the worst start to a holiday.

0:03:22 > 0:03:25Fortunately, Endsleigh's policyholder was covered for the

0:03:25 > 0:03:28loss, so he phoned to get the ball rolling with his claim.

0:04:03 > 0:04:06Ordinarily, claiming to be the victim of a three-wheeled bandit

0:04:06 > 0:04:08would raise eyebrows.

0:04:08 > 0:04:10But as this was Sri Lanka,

0:04:10 > 0:04:12where tuk-tuks are on the street in their thousands,

0:04:12 > 0:04:15it seemed perfectly plausible.

0:04:15 > 0:04:18From the information that had been provided, the claim appeared

0:04:18 > 0:04:21genuine, and actually, for this type of claim,

0:04:21 > 0:04:24you felt some sympathy for the customer.

0:04:24 > 0:04:28However, when Endsleigh received the claim form and supporting documents,

0:04:28 > 0:04:30that sympathy began to turn into suspicion.

0:04:31 > 0:04:36The customer provided documentation in the form of a police report,

0:04:36 > 0:04:38and also itinerary, in terms of the actual visit.

0:04:39 > 0:04:44But at this stage, they also added on £250 for a cash withdrawal,

0:04:44 > 0:04:47and additional clothing items which were worth over £600.

0:04:48 > 0:04:52Straight away, you're questioning in terms of why the customer didn't

0:04:52 > 0:04:56add the cash withdrawal and the additional clothing when they

0:04:56 > 0:04:58initially reported the claim to us.

0:04:58 > 0:05:00It's a fair comment.

0:05:00 > 0:05:03Forgetting a few pairs of socks or a T-shirt is one thing,

0:05:03 > 0:05:09but £250 in cash and another £600-worth of clothes just didn't add up.

0:05:11 > 0:05:14And that wasn't the only concern with the claim.

0:05:15 > 0:05:19When we looked in further detail and investigated the various

0:05:19 > 0:05:21documentation that had been supported,

0:05:21 > 0:05:25then it was clear that some of the documents had actually been doctored.

0:05:26 > 0:05:29There was a date stamp on a police report, that was clear, had been

0:05:29 > 0:05:32changed from 2012 to 2014.

0:05:34 > 0:05:40The date of the actual incident was confirmed as Wednesday the 26th,

0:05:40 > 0:05:44whereby there wasn't a Wednesday 26th in 2014.

0:05:44 > 0:05:46There was in 2012.

0:05:46 > 0:05:50So there were all kinds of inconsistencies in terms of the documentation

0:05:50 > 0:05:52that the customer provided us with.

0:05:52 > 0:05:54With those inconsistencies piling up,

0:05:54 > 0:05:57it was time to get some answers from the claimant himself.

0:07:02 > 0:07:03Oh.

0:07:05 > 0:07:06For Simon and his team,

0:07:06 > 0:07:11the customer's stunted and stuttering responses spoke volumes.

0:07:11 > 0:07:15Straight away, you could tell that the customer started to hesitate and

0:07:15 > 0:07:18some of the responses that they actually gave just didn't tie up

0:07:18 > 0:07:21with the actual incident circumstances that had been provided.

0:08:10 > 0:08:15With documents that appeared to be have been changed from 2012 to 2014,

0:08:15 > 0:08:18and £850-worth of items added to the claim,

0:08:18 > 0:08:22the insurance company thought they knew exactly what was going on.

0:08:24 > 0:08:27It appeared that potentially the customer had previously claimed for

0:08:27 > 0:08:30this, and had claimed in 2012,

0:08:30 > 0:08:33so what they were potentially looking to do was just lodge another

0:08:33 > 0:08:36claim, exactly the same as the one that they'd previously done,

0:08:36 > 0:08:40using the same evidence, the same police report, the same documentation -

0:08:40 > 0:08:44but doctor the documents to be able to support the fact that this claim

0:08:44 > 0:08:47happened in 2014 and not in 2012.

0:08:48 > 0:08:52So, due to the inconsistencies on this particular claim,

0:08:52 > 0:08:57we not only declined the claim but we also added it on to the IFIG

0:08:57 > 0:09:01list, which is the Insurance Fraud Investigators Group...

0:09:01 > 0:09:05..and also onto our own database,

0:09:05 > 0:09:09and from this we were contacted by another insurer that confirmed that

0:09:09 > 0:09:12they'd got a duplicate case almost exactly the same.

0:09:12 > 0:09:16The phone call between Endsleigh and the other insurer the customer was

0:09:16 > 0:09:19also attempting to claim with, was the final nail in the coffin.

0:10:11 > 0:10:15It was crystal clear that this chancer had targeted both Endsleigh

0:10:15 > 0:10:19and the other company, but his sloppiness and greed were his undoing.

0:10:19 > 0:10:21However, as Simon explains,

0:10:21 > 0:10:24this could have been just the tip of the iceberg.

0:10:24 > 0:10:29This confirmed our concerns that this was a fraudulent claim, and

0:10:29 > 0:10:32that not only had they lodged a fraudulent claim with us,

0:10:32 > 0:10:36but they were also potentially lodging multiple fraudulent claims

0:10:36 > 0:10:37with other insurance companies.

0:10:37 > 0:10:41Hopefully, as a result of picking this one up and repudiating it,

0:10:41 > 0:10:44not only did we stop this claim, but also the other claim with the other

0:10:44 > 0:10:46insurance company, as well,

0:10:46 > 0:10:49so hopefully this customer will no longer be making fraudulent cases.

0:10:57 > 0:11:01A claimant involves his own unsuspecting father in a scam to

0:11:01 > 0:11:03maximise his gain.

0:11:03 > 0:11:08For me, this demonstrates that Niku was fuelled by greed...

0:11:09 > 0:11:13..and didn't care who suffered as a result.

0:11:13 > 0:11:14And in the USA,

0:11:14 > 0:11:18a fraudster's barbaric attempt to cheat the system results in a

0:11:18 > 0:11:20life-changing injury for his victim.

0:11:27 > 0:11:32The UK is home to the fourth-largest insurance industry in the world,

0:11:32 > 0:11:34behind America, Japan and China,

0:11:34 > 0:11:40paying out £40 million every day in motor and property claims alone.

0:11:40 > 0:11:43Most of us have standard types of insurance for our home,

0:11:43 > 0:11:45our car and for travelling abroad,

0:11:45 > 0:11:50but today you can take out a policy to protect yourself from almost anything -

0:11:50 > 0:11:55from an alien invasion, to an attack from the Loch Ness Monster.

0:12:00 > 0:12:04Some types of cover, like car insurance, are compulsory.

0:12:06 > 0:12:09Others, like caravan insurance, for example, aren't.

0:12:11 > 0:12:15But if you don't protect high-value items like this and they're stolen,

0:12:15 > 0:12:17you could be left high and dry.

0:12:20 > 0:12:22For more unusual items,

0:12:22 > 0:12:26you might need to contact a specialist company like Towergate.

0:12:27 > 0:12:32They insure items that others won't touch, from boats, to

0:12:32 > 0:12:33horses, to skydiving trips,

0:12:33 > 0:12:39and recently had a claim from a Mr Wright regarding the theft of his insured caravan.

0:12:39 > 0:12:43The customer told us that he was returning from his holiday and that

0:12:43 > 0:12:47he was taking his caravan back to where he kept it in storage.

0:12:47 > 0:12:50He then told us that, on the way to storage,

0:12:50 > 0:12:53he had actually broken down and had pulled in.

0:12:53 > 0:12:56He'd had a problem with his vehicle before and he knew what the

0:12:56 > 0:12:59problem was, and he felt that by pulling into a lay-by he could fix

0:12:59 > 0:13:03the problem and then take the caravan back to its storage place.

0:13:03 > 0:13:06Unable to repair his broken motor,

0:13:06 > 0:13:08Mr Wright phoned his breakdown service.

0:13:10 > 0:13:12A recovery vehicle was unavailable,

0:13:12 > 0:13:15so the policyholder left the vehicle, with the caravan attached to it,

0:13:15 > 0:13:19overnight. When the policyholder returned the following morning,

0:13:19 > 0:13:20the caravan had gone.

0:13:22 > 0:13:24Wow! That's a pretty big loss.

0:13:24 > 0:13:28Luckily, this gentleman had insured his prized possession.

0:13:28 > 0:13:31The full sum insured for the caravan was £30,000,

0:13:31 > 0:13:34plus there was unspecified contents cover as well.

0:13:34 > 0:13:37So, in all, it was a £35,000 claim.

0:13:37 > 0:13:42But as the initial call progressed, something didn't seem quite right.

0:13:42 > 0:13:46£35,000 is a significant caravan loss.

0:13:46 > 0:13:49However, the customer seemed very relaxed about this.

0:13:49 > 0:13:53The claims handler was also concerned that the customer was

0:13:53 > 0:13:57extremely interested in how much he would be paid, very early in the call.

0:13:57 > 0:14:01Towergate decided to refer the case to the policy underwriters, Allianz,

0:14:01 > 0:14:03to talk through their concerns.

0:14:05 > 0:14:07When claims come into Allianz,

0:14:07 > 0:14:11we make sure that we go through kind of a validation process.

0:14:11 > 0:14:15And during that process we have to carry out some standard investigations.

0:14:19 > 0:14:22The initial background check that was carried out in this case

0:14:22 > 0:14:25established that the individual concerned had a number of

0:14:25 > 0:14:29County Court judgments against their name.

0:14:29 > 0:14:33This indicated to us that there were some financial problems with the

0:14:33 > 0:14:36individual concerned, and therefore it's something that we

0:14:36 > 0:14:38wanted to have a look into in a bit more detail.

0:14:38 > 0:14:42Allianz also checked Mr Wright's mobile phone records for the day in

0:14:42 > 0:14:46question, expecting to find the call to the breakdown service.

0:14:47 > 0:14:52Unfortunately, there was no evidence of any calls being made to a

0:14:52 > 0:14:58recovery garage on the evening of the alleged breakdown, in order to

0:14:58 > 0:15:01try and secure the vehicle and the caravan into safe storage.

0:15:03 > 0:15:04With alarm bells ringing,

0:15:04 > 0:15:08Allianz decided to contact the dealer who sold the caravan to Mr Wright,

0:15:08 > 0:15:10to check it actually existed.

0:15:11 > 0:15:15Whilst they confirmed that the sale was genuine,

0:15:15 > 0:15:18they also confirmed that, due to nonpayment of financials,

0:15:18 > 0:15:25they'd actually issued a High Court summons against the policyholder for recovery of outstanding finance.

0:15:27 > 0:15:29So, as a result of these enquiries,

0:15:29 > 0:15:34we established that the policyholder had in fact County Court judgments

0:15:34 > 0:15:39close to £10,000 that were against their name,

0:15:39 > 0:15:42and £1,700 of which related to the caravan in question.

0:15:44 > 0:15:48It was all starting to make wheelie good sense.

0:15:48 > 0:15:52Allianz then made contact with the caravan site Mr Wright said he'd

0:15:52 > 0:15:55visited the weekend before the alleged theft.

0:15:55 > 0:16:00The purpose of contacting the site was to validate the policyholder's

0:16:00 > 0:16:03story that he was actually on site over that weekend.

0:16:03 > 0:16:08To our surprise, what we actually established was that,

0:16:08 > 0:16:11whilst they had the caravan on site over that weekend,

0:16:11 > 0:16:15at no point did the policyholder actually attend site.

0:16:15 > 0:16:18But what they found out next was astonishing.

0:16:19 > 0:16:23The real surprise was when they went on to say that they still actually

0:16:23 > 0:16:25had the caravan on site,

0:16:25 > 0:16:29and it actually had never left that site over the weekend.

0:16:30 > 0:16:33And at this point, we realised that the caravan was still in the

0:16:33 > 0:16:35possession of the policyholder.

0:16:37 > 0:16:40So the theft had been staged to claim the insurance money.

0:16:41 > 0:16:43Discussion was taken with Towergate

0:16:43 > 0:16:46to report the matter to the police for further action.

0:16:47 > 0:16:50Mr Wright was arrested, and quickly admitted he had made up the

0:16:50 > 0:16:52circumstances of the claim

0:16:52 > 0:16:55in an attempt to get the money to pay off his debts.

0:16:56 > 0:17:01At court, the policyholder pleaded guilty to insurance fraud.

0:17:01 > 0:17:04The policyholder was then sentenced to six months' imprisonment,

0:17:04 > 0:17:07which was suspended for 12 months...

0:17:07 > 0:17:11..on the order that he was to wear an electronic tag between the hours

0:17:11 > 0:17:15of 8am and 8pm every day.

0:17:16 > 0:17:19It was a great result for both Towergate and Allianz,

0:17:19 > 0:17:23who'd worked hard to ensure this fraudster got what he deserved.

0:17:24 > 0:17:25In circumstances like this,

0:17:25 > 0:17:29people may feel that insurance fraud is a quick win,

0:17:29 > 0:17:31an easy way to make money, and

0:17:31 > 0:17:34perhaps don't understand the severity of the punishment attached to the crime.

0:17:34 > 0:17:40It's therefore great in these circumstances when a severe sentence is handed down.

0:17:40 > 0:17:43This really helps us, as an insurance

0:17:43 > 0:17:47industry, showcase the implications

0:17:47 > 0:17:52of what insurance fraud looks like to individuals, and therefore

0:17:52 > 0:17:56hopefully deter people from bringing claims of this nature in the future.

0:18:02 > 0:18:05Sometimes people will go to astonishing lengths to commit

0:18:05 > 0:18:07carefully planned fraud,

0:18:07 > 0:18:11but what's even more shocking is when they involve innocent friends

0:18:11 > 0:18:15or their own family members, all in pursuit of making a few quid.

0:18:18 > 0:18:22We're all told how important it is to give accurate details when

0:18:22 > 0:18:24filling out forms for an insurance policy.

0:18:26 > 0:18:30But what if those details were deliberately changed after they'd

0:18:30 > 0:18:32been submitted to an insurance broker,

0:18:32 > 0:18:36reducing the premium, but completely invalidating the policy?

0:18:38 > 0:18:41When insurance companies uncover suspect claims,

0:18:41 > 0:18:44they're passed on to the Insurance Fraud Bureau, or IFB.

0:18:47 > 0:18:50Jason Potter is head of investigations there

0:18:50 > 0:18:54and was contacted by a motor insurer who thought they had a bogus claim.

0:18:56 > 0:19:01An alert was received within the Insurance Fraud Bureau that a

0:19:01 > 0:19:06suspicious accident had been received by the insurer,

0:19:06 > 0:19:11and they would like us to assess whether that linked to any other

0:19:11 > 0:19:14incidents that we were aware of.

0:19:14 > 0:19:19The IFB investigated the case and found that someone posing as an

0:19:19 > 0:19:23insurance broker was taking out policies on behalf of his clients.

0:19:23 > 0:19:25Unbeknown to them,

0:19:25 > 0:19:28he was then changing their details in order to get cheaper cover,

0:19:28 > 0:19:32therefore completely invalidating the insurance.

0:19:33 > 0:19:35This is known as ghost broking.

0:19:37 > 0:19:41The usual scam would be to approach the individual,

0:19:41 > 0:19:45gather their information and then take money for that service.

0:19:47 > 0:19:52This can range from £100 to £1,000.

0:19:54 > 0:19:57They'll then engage with a legitimate insurer, in order to

0:19:57 > 0:20:02facilitate cover. However, what they will do is change the information

0:20:02 > 0:20:06that the individual gave them in the first instance to fictitious

0:20:06 > 0:20:11information, in order to reduce the overall cost of the insurance.

0:20:12 > 0:20:16The ghost broker will go on his way and the victim will go out onto the

0:20:16 > 0:20:19road and drive as if they are insured,

0:20:19 > 0:20:22when in fact there's no cover in force.

0:20:24 > 0:20:26So, let me get this straight.

0:20:26 > 0:20:30Step one - get details from innocent members of the public.

0:20:30 > 0:20:35Step two - charge a brokerage fee to take out the policies on their behalf.

0:20:35 > 0:20:39Step three, manipulate the details to get cheaper cover.

0:20:39 > 0:20:41Got it.

0:20:42 > 0:20:46The man behind this particular scam was Hojat Niku,

0:20:46 > 0:20:49but he wasn't just acting as a ghost broker -

0:20:49 > 0:20:52he was also approaching insurers directly and making fictitious

0:20:52 > 0:20:56claims against the policies he'd taken out.

0:20:56 > 0:21:00The spectrum of claims that Niku was trying to make, involved personal

0:21:00 > 0:21:05injury, vehicle damage, storage...

0:21:06 > 0:21:07..and hire costs.

0:21:09 > 0:21:13Ultimately, what he wanted to do was maximise his financial benefit out of this scam.

0:21:15 > 0:21:20Overall, Niku's claims affected 25 different insurance companies and

0:21:20 > 0:21:22countless innocent victims.

0:21:24 > 0:21:27The people that Niku targeted were largely from a Turkish and Iranian

0:21:27 > 0:21:31background. They were not fully familiar with the UK insurance industry.

0:21:31 > 0:21:35Therefore, the majority of these individuals would have assumed that

0:21:35 > 0:21:38Niku was acting in their best interests,

0:21:38 > 0:21:42and providing them with legitimate insurance cover, to enable them to

0:21:42 > 0:21:46use the roads. If they had been stopped by the police...

0:21:47 > 0:21:51..they would have been prosecuted for no insurance.

0:21:51 > 0:21:56They would have received a heavy fine and points on their licence.

0:21:56 > 0:22:01Worst of all, Mr Niku was so greedy he even took out a claim against a

0:22:01 > 0:22:04policy belonging to one of his own family members.

0:22:07 > 0:22:09In one instance,

0:22:09 > 0:22:11he stooped so low as to try and

0:22:11 > 0:22:14instigate a claim on his father's policy.

0:22:14 > 0:22:21For me, this demonstrates that Niku was fuelled by greed

0:22:21 > 0:22:26and didn't care who suffered as a result of his necessity...

0:22:26 > 0:22:30..to instigate fraudulent claims.

0:22:32 > 0:22:35But when he phoned the insurance company, pretending to be his

0:22:35 > 0:22:38father, he hit a stumbling block.

0:22:38 > 0:22:39Unfortunately for Niku,

0:22:39 > 0:22:42the insurer's security questions caught him out.

0:22:43 > 0:22:45On three separate occasions,

0:22:45 > 0:22:50he couldn't answer a simple question as to what his father's date of

0:22:50 > 0:22:56birth was. In the end, the insurer simply asked him, "How old are you?"

0:22:56 > 0:22:58and he even got that wrong.

0:22:59 > 0:23:04Jason and his team fed the information they'd gathered to the City of London Police.

0:23:06 > 0:23:12The extent of the claims that we sent to Ifed were valued at around £140,000,

0:23:12 > 0:23:17which they then focused upon, in order to take forward to prosecution.

0:23:18 > 0:23:23The case proceeded to trial and Niku pleaded guilty.

0:23:23 > 0:23:26As a result, he received 21 months' imprisonment.

0:23:26 > 0:23:28That was suspended for two years.

0:23:30 > 0:23:33From our perspective, that was a good result.

0:23:33 > 0:23:39It justified the hard work that the Insurance Fraud Bureau, Ifed

0:23:39 > 0:23:42and the insurance industry had put into this case.

0:23:44 > 0:23:49Jason has one final piece of advice to anyone looking to take out a car insurance policy.

0:23:51 > 0:23:56To ensure that you are liaising with a legitimate source of insurance...

0:23:58 > 0:24:05..please check that brokers are registered with the FCA,

0:24:05 > 0:24:11use price comparison websites, or, if going direct to an insurer,

0:24:11 > 0:24:14make sure that they are members of the Motor Insurers Bureau.

0:24:19 > 0:24:26Every year, there are around 180,000 accidents on Britain's roads resulting in injury.

0:24:26 > 0:24:29But sometimes you don't even have to be on the road to experience a car

0:24:29 > 0:24:35crash, as about two thirds of us have had our vehicle damaged in a car park.

0:24:37 > 0:24:38When accidents happen,

0:24:38 > 0:24:42insurance policies are there to protect both parties.

0:24:42 > 0:24:46Sadly, some people see them as an opportunity to make money.

0:24:47 > 0:24:50But often their stories are ill-conceived and badly executed,

0:24:50 > 0:24:53and eventually they do get found out.

0:24:55 > 0:24:59Direct Line recently dealt with a case where, initially, everything

0:24:59 > 0:25:01seemed to be above board.

0:25:01 > 0:25:08Mr Jiwarski claimed that on the 27th of April, 2016,

0:25:08 > 0:25:15he was reversing out of a parking bay at the bowling alley in Derby,

0:25:15 > 0:25:19and, in doing so, he collided with a Vauxhall Vectra...

0:25:20 > 0:25:22..which contained three occupants.

0:25:22 > 0:25:27Mr Jiwarski reported minor damage to his vehicle, and the other party,

0:25:27 > 0:25:31the Dosang family, said minor damage had been done to theirs.

0:25:31 > 0:25:38Having received versions of events from both Mr Jiwarski and the Dosang family,

0:25:38 > 0:25:42the events appeared to tally very closely with each other.

0:25:42 > 0:25:44Nothing was untoward.

0:25:44 > 0:25:48Both parties were also claiming for injury.

0:25:48 > 0:25:52In this type of low-speed accident, minor bruising would be pushing it,

0:25:52 > 0:25:56but all four occupants were claiming for soft tissue damage,

0:25:56 > 0:25:58akin to a much higher-speed accident.

0:25:59 > 0:26:03Soft tissue injuries, in a situation such as this

0:26:03 > 0:26:10where you've got a vehicle reversing steadily out of a parking space into

0:26:10 > 0:26:14what would be a slow-moving vehicle driving around a car park...

0:26:16 > 0:26:22..it would be unrealistic to expect any persons to sustain the level of

0:26:22 > 0:26:25soft tissue injuries that was being portrayed.

0:26:25 > 0:26:29In total, the claims added up to just over £29,000,

0:26:29 > 0:26:33but Direct Line weren't exactly bowled over by the individual

0:26:33 > 0:26:37stories, and had no intention of paying out just yet.

0:26:37 > 0:26:42With those concerns in mind, the first phase is to refer this claim,

0:26:42 > 0:26:46for further validation, to our counter-fraud department.

0:26:48 > 0:26:53Their examination revealed that the damages to both vehicles were not

0:26:53 > 0:26:59consistent with what was being reported on the claims form,

0:26:59 > 0:27:03so if we were to reconstruct the accident and put the vehicles back

0:27:03 > 0:27:08in situ, as outlined in the claim, then the damage would not correlate.

0:27:09 > 0:27:13With the ball in their court, the next step was to contact the bowling

0:27:13 > 0:27:16alley where the accident took place.

0:27:16 > 0:27:19Fortunately, we were able to view CCTV

0:27:19 > 0:27:23footage of their external car park.

0:27:23 > 0:27:27We've gone back to the time and date in question, and here we are

0:27:27 > 0:27:31looking at the location of the alleged accident,

0:27:31 > 0:27:35and I am waiting to see a Ford Fiesta reverse out of the parking

0:27:35 > 0:27:38bay and into a Vauxhall Vectra.

0:27:39 > 0:27:40They waited...

0:27:41 > 0:27:42..and waited...

0:27:44 > 0:27:45..and waited.

0:27:46 > 0:27:49There is no Ford Fiesta or Vauxhall

0:27:49 > 0:27:54Vectra at the location on the specific time and date.

0:27:55 > 0:27:57It is not there.

0:27:57 > 0:27:59Maybe they'd got the day right but hadn't remembered the

0:27:59 > 0:28:01time of the accident correctly.

0:28:01 > 0:28:04We examined the CCTV further,

0:28:04 > 0:28:08several hours either side of the time and date in question,

0:28:08 > 0:28:12and at no time could we visually see

0:28:12 > 0:28:15the Fiesta or the Vauxhall Vectra ever

0:28:15 > 0:28:18entering the bowling alley's car park.

0:28:19 > 0:28:23So we know neither party visited the car park,

0:28:23 > 0:28:25but did they even go bowling?

0:28:26 > 0:28:31This particular alley operates on a pre-booked basis only,

0:28:31 > 0:28:34so Direct Line asked to see the records for that day.

0:28:35 > 0:28:41Upon inspection, neither Mr Jiwarski nor the Dosang family

0:28:41 > 0:28:47had pre-booked any bowling facilities for the day in question of the accident,

0:28:47 > 0:28:51which means the whole thing is a sham, it's a lie,

0:28:51 > 0:28:53the accident never took place,

0:28:53 > 0:28:54the vehicles were never on site,

0:28:54 > 0:28:59and neither the Dosangs or Jiwarski visited that location.

0:28:59 > 0:29:03It was a classic case of, "Three strikes and you're out..."

0:29:03 > 0:29:06..and a blatant attempt to defraud Direct Line.

0:29:06 > 0:29:10The evidence was handed to Staffordshire Police, who conducted an investigation.

0:29:11 > 0:29:17They arrested all four of the claimants and subsequently charged

0:29:17 > 0:29:20them with conspiracy to defraud.

0:29:20 > 0:29:24They then appeared at Stafford Crown Court and received custodial sentences.

0:29:26 > 0:29:31Both drivers received, in terms of imprisonment, one of ten months, one of nine months.

0:29:31 > 0:29:37The passengers, albeit a lesser part, received four months apiece, albeit suspended.

0:29:42 > 0:29:47Clearly this sends a significant message to those who would seek to

0:29:47 > 0:29:50commit insurance fraud at whatever level.

0:29:50 > 0:29:54It is not a victimless crime and you

0:29:54 > 0:29:58will receive custodial prison sentences,

0:29:58 > 0:30:02and your lives will be changed forever.

0:30:06 > 0:30:08Still to come -

0:30:08 > 0:30:12a conniving couple attempt to profit from an audacious bus scam.

0:30:14 > 0:30:16So you know that an impact has taken place,

0:30:16 > 0:30:19but it wasn't a case of the bus hitting the car in the rear.

0:30:24 > 0:30:27Now, we all like to be in control of our own finances,

0:30:27 > 0:30:30even if we're not very good at it sometimes.

0:30:30 > 0:30:33But if we become ill and are unable to cope,

0:30:33 > 0:30:36friends and family often step in to help out.

0:30:36 > 0:30:39These are the people we trust the most,

0:30:39 > 0:30:42so they'd seem like the perfect candidates for the job.

0:30:42 > 0:30:47Unfortunately, some fraudsters will abuse this trust, to make money.

0:30:49 > 0:30:51And if you think it's bad in the UK,

0:30:51 > 0:30:57the lengths some fraudsters go to on the other side of the Atlantic is simply incredible.

0:30:58 > 0:31:04In America, the cost of insurance fraud is estimated to be over 40 billion a year.

0:31:04 > 0:31:07That's more than 30 times that of the UK.

0:31:13 > 0:31:15In Sumter County, South Carolina,

0:31:15 > 0:31:19David Player and Michael Weaver had a long-standing friendship.

0:31:20 > 0:31:24Weaver had learning difficulties, so Player would often care for him.

0:31:25 > 0:31:29To any outsider, Player was the perfect companion for Weaver,

0:31:29 > 0:31:32and the two had a strong bond.

0:31:32 > 0:31:35Player was also friends with another man, Gerald Harding,

0:31:35 > 0:31:38and the three of them tended to hang out together.

0:31:39 > 0:31:41In May 2008,

0:31:41 > 0:31:44Player and Harding rushed Weaver to the emergency room at a local

0:31:44 > 0:31:46medical centre in Sumter.

0:31:50 > 0:31:53They told the nurse that Weaver had been helping to trim trees on

0:31:53 > 0:31:57Player's property, when his left forearm had been completely severed.

0:31:59 > 0:32:03It turned out they'd been using a pole saw to chop off branches,

0:32:03 > 0:32:07while Weaver pulled them aside to stop them getting caught up.

0:32:08 > 0:32:12The saw had suddenly slipped at the wrong moment,

0:32:12 > 0:32:15cutting Weaver's hand off.

0:32:15 > 0:32:18It appeared to be an unfortunate accident,

0:32:18 > 0:32:21but one that would change Weaver's life forever.

0:32:24 > 0:32:28When the emergency room nurse examined the injury, she noticed the

0:32:28 > 0:32:30cut itself was surprisingly clean,

0:32:30 > 0:32:33with little damage to the surrounding tissue,

0:32:33 > 0:32:35as would be expected with a saw accident.

0:32:38 > 0:32:41Doctors later attempted to reattach Weaver's hand.

0:32:44 > 0:32:46But the operation was sadly unsuccessful,

0:32:46 > 0:32:48and it had to be amputated.

0:32:52 > 0:32:56Luckily, Player had taken out insurance policies on behalf of his

0:32:56 > 0:33:00vulnerable friend, Weaver, for whom he had power of attorney.

0:33:00 > 0:33:03These consisted of multiple accidental death

0:33:03 > 0:33:04and dismemberment policies...

0:33:07 > 0:33:12..as well as a 400,000 liability policy on his own property.

0:33:15 > 0:33:18The insurance company quickly settled the claim on his property

0:33:18 > 0:33:23for 375,000, and began processing the claims for Weaver.

0:33:26 > 0:33:30Player received payment without any problem at all, and claimed he

0:33:30 > 0:33:33placed the money into accounts largely for the benefit of Weaver.

0:33:33 > 0:33:38Altogether, he received over 671,000 -

0:33:38 > 0:33:43around £540,000.

0:33:43 > 0:33:45So, a hefty pay-out,

0:33:45 > 0:33:49but seemingly well-deserved for a life-changing injury.

0:33:49 > 0:33:53But what happened next was to throw everything into disrepute.

0:33:55 > 0:33:59The following year, Player and his wife went through a divorce.

0:33:59 > 0:34:03While clearing out the house, she discovered a briefcase belonging to

0:34:03 > 0:34:04her estranged husband.

0:34:06 > 0:34:10It contained around 30 credit cards, all in Weaver's name...

0:34:11 > 0:34:15..as well as the details of the accidental death and dismemberment

0:34:15 > 0:34:17policies Player had taken out on his behalf.

0:34:20 > 0:34:23Some named Player as the beneficiary.

0:34:23 > 0:34:27The ex-wife handed the evidence over to her attorney,

0:34:27 > 0:34:31who then passed it on to the FBI.

0:34:31 > 0:34:34It wasn't until the FBI began their investigations that they discovered

0:34:34 > 0:34:41Player had indeed been playing the system and had taken out the credit cards in Weaver's name.

0:34:41 > 0:34:46The vulnerable Weaver had unknowingly become a victim of his friend's scam.

0:34:48 > 0:34:52When interviewed, Weaver denied all knowledge of the accounts.

0:34:52 > 0:34:56He also denied giving Player permission to open accounts in the first place.

0:34:58 > 0:35:04The investigator discovered that Player had used the money from the claims to buy a house for his son,

0:35:04 > 0:35:06to build on his own existing property,

0:35:06 > 0:35:09and to even purchase a car for his friend, Harding.

0:35:09 > 0:35:13Little, if any, of the proceeds had been spent on Weaver.

0:35:15 > 0:35:18Harding was brought in for interview and when confronted with his

0:35:18 > 0:35:20original statement, he refuted it.

0:35:21 > 0:35:25Harding claimed he'd been part of a scam led by Player to make

0:35:25 > 0:35:29fraudulent insurance claims based on the amputation of Weaver's hand.

0:35:30 > 0:35:34He told investigators how they'd tied Weaver's arm to a branch and

0:35:34 > 0:35:37deliberately cut off his hand with a pole saw.

0:35:39 > 0:35:42Harding claimed the scheme had been designed by Player for his own

0:35:42 > 0:35:46financial benefit, and, together with Weaver,

0:35:46 > 0:35:49had been enticed into it with the promise of a monetary reward.

0:35:53 > 0:35:55Four years after the incident, the

0:35:55 > 0:35:58FBI had all the evidence they needed.

0:35:58 > 0:36:04Player was finally found guilty of fraud and sentenced to 14 years in prison.

0:36:04 > 0:36:09He was also ordered to pay back the...

0:36:11 > 0:36:18Harding pleaded guilty to fraud and received a three-year sentence for his role.

0:36:18 > 0:36:20In this cruel and heartless case,

0:36:20 > 0:36:24a man unable to fully care for himself put all his trust in a close friend.

0:36:25 > 0:36:29But what his friend did was to abuse this trust beyond belief,

0:36:29 > 0:36:34not only by inflicting a debilitating injury on him, but also

0:36:34 > 0:36:38by stealing the compensation money that had been intended for Weaver.

0:36:39 > 0:36:43It just goes to show that sometimes it's the people you least expect

0:36:43 > 0:36:46and those who you have the closest bond with

0:36:46 > 0:36:49that can end up being your worst enemies.

0:36:54 > 0:36:58Fraudsters will try anything to make a quick bit of cash, from damaging

0:36:58 > 0:37:02their own property to causing physical harm to themselves.

0:37:02 > 0:37:07There are around 130,000 fraudulent claims made every year.

0:37:07 > 0:37:13Incredibly, £2 billion-worth is believed to go undetected.

0:37:17 > 0:37:21But insurance companies are finding more and more ways of disproving

0:37:21 > 0:37:25fraudulent claims, largely thanks to improvements in technology.

0:37:26 > 0:37:30CCTV footage has rumbled many a fraudster,

0:37:30 > 0:37:34providing vital evidence in claims that may otherwise have been accepted.

0:37:35 > 0:37:39It's something which Lee Ingram at FirstGroup is all too familiar with.

0:37:42 > 0:37:45We received a claim following an incident that occurred between one

0:37:45 > 0:37:49of our buses and a car that had been stationary at a set of traffic lights.

0:37:49 > 0:37:53They were alleging that we'd hit them in the rear whilst they were stationary.

0:37:53 > 0:37:57The injuries ranged from soft tissue injuries to the shoulders,

0:37:57 > 0:37:59neck and back,

0:37:59 > 0:38:02through to some minor chest injuries.

0:38:02 > 0:38:04They're typically indicative of

0:38:04 > 0:38:08the sort of injuries you would see from this type of rear-end collision.

0:38:08 > 0:38:11All told, this claim would have been worth around about £15,000,

0:38:11 > 0:38:14including the personal injury, damage to the vehicle and

0:38:14 > 0:38:16legal costs.

0:38:16 > 0:38:19It seemed like a pretty straightforward case.

0:38:19 > 0:38:22Rear-end collisions are fairly common, so no eyebrows were raised.

0:38:24 > 0:38:27Lee and his team set about investigating the claim by getting

0:38:27 > 0:38:29statements from both the bus and car drivers.

0:38:31 > 0:38:35The only problem was, they didn't quite match up.

0:38:35 > 0:38:37In this case,

0:38:37 > 0:38:41the driver's report differed slightly from the allegations being

0:38:41 > 0:38:47made by the claimant, so we thought, "This is one that we need to have a bit of a deeper look at."

0:38:47 > 0:38:51Luckily, they had the perfect tool at their disposal.

0:38:51 > 0:38:56The easiest way of clearing up any differences in opinion or disputes

0:38:56 > 0:38:58is to have a look at the CCTV footage,

0:38:58 > 0:39:02so we quickly downloaded that and we had a look at it,

0:39:02 > 0:39:04to see what it was going to show us.

0:39:04 > 0:39:08All FirstGroup buses are fitted with onboard CCTV cameras,

0:39:08 > 0:39:13which come in very handy when stories simply don't match.

0:39:13 > 0:39:14So the claim has been put in,

0:39:14 > 0:39:19alleging that we've struck a vehicle in the rear at traffic lights,

0:39:19 > 0:39:22and we can see the vehicles approaching the traffic lights here,

0:39:22 > 0:39:26so what I'm expecting to see is the car coming to the lights, stopping,

0:39:26 > 0:39:30and then the bus not stopping, and just striking the car in the rear.

0:39:30 > 0:39:35But on closer inspection, the camera's painted a very different picture.

0:39:35 > 0:39:38What we actually see is something completely different.

0:39:38 > 0:39:41The bus does pull up behind the car and it stops.

0:39:41 > 0:39:44They're both there for a little bit,

0:39:44 > 0:39:45neither vehicle moving.

0:39:45 > 0:39:47And then, slowly, very slowly,

0:39:47 > 0:39:49almost imperceptibly,

0:39:49 > 0:39:51you see the claimant's vehicle

0:39:51 > 0:39:53start to roll backwards.

0:39:53 > 0:39:56You can actually see a slight bump occur...

0:39:57 > 0:40:02..so you know that an impact has taken place, but it wasn't a case of

0:40:02 > 0:40:04the bus hitting the car in the rear.

0:40:04 > 0:40:08From this camera angle, we can see the bus is at a standstill.

0:40:08 > 0:40:12And if you look to the right, here comes the car rolling into the bus.

0:40:14 > 0:40:15Let's check another angle.

0:40:18 > 0:40:19Yeah, no mistake.

0:40:19 > 0:40:21It's the car that hits the bus.

0:40:22 > 0:40:27At this point, the footage itself lays waste to any potential

0:40:27 > 0:40:30allegations that have been made by the claimant.

0:40:30 > 0:40:34There's just no way that it follows the circumstances they've described.

0:40:35 > 0:40:38So, the initial claim was rejected.

0:40:38 > 0:40:41But this chancer wasn't prepared to give up easily.

0:40:41 > 0:40:45When we went back to the claimant and told them what the CCTV was

0:40:45 > 0:40:48showing, they said that the driver of the bus was looking at some

0:40:48 > 0:40:51paperwork immediately before the collision.

0:40:51 > 0:40:54Now, looking at the CCTV footage,

0:40:54 > 0:41:00no way was the driver looking at any paperwork before this incident happened.

0:41:00 > 0:41:04This is just, really, a sad attempt to try and discredit the

0:41:04 > 0:41:09driver and to muddy the waters of what actually caused the accident to happen.

0:41:09 > 0:41:11So first of all,

0:41:11 > 0:41:14they claimed the bus hit them while they were stationary,

0:41:14 > 0:41:17then we find out it wasn't the bus that hit the car,

0:41:17 > 0:41:19but the other way around, and then

0:41:19 > 0:41:20they try and blame the accident on

0:41:20 > 0:41:23the bus driver, saying he was looking at paperwork

0:41:23 > 0:41:26when the incident happened...

0:41:26 > 0:41:27None of which is true.

0:41:28 > 0:41:30It could have ended there,

0:41:30 > 0:41:34but it seems this couple were hell-bent on winning the case and

0:41:34 > 0:41:36had one more trick up their sleeves.

0:41:36 > 0:41:40They also said that the road was flat, so they couldn't have rolled back.

0:41:40 > 0:41:44Now, looking at the footage and the evidence that we had,

0:41:44 > 0:41:48we can quite clearly show that the bus was stationary,

0:41:48 > 0:41:53so the only real cause of the collision was the car rolling back into the bus.

0:41:53 > 0:41:57With nothing else around the bus actually moving,

0:41:57 > 0:42:01the CCTV footage had once again come up trumps.

0:42:02 > 0:42:04We turned down the claim again,

0:42:04 > 0:42:08saying that we didn't accept that the road was flat.

0:42:08 > 0:42:11We were quite happy that the bus was stationary at all times and it was

0:42:11 > 0:42:15their vehicle that had rolled back into the bus and not the other way round.

0:42:15 > 0:42:19It seems this couple had finally run out of options, and had been

0:42:19 > 0:42:21left without a leg to stand on.

0:42:21 > 0:42:25For Lee, it was another dodgy claim put to bed.

0:42:25 > 0:42:28Whenever we get claims that are presented to us and we have

0:42:28 > 0:42:32sufficient evidence to suggest that the claim is anything other than

0:42:32 > 0:42:36genuine, we will always fight these claims.

0:42:36 > 0:42:40There's no way we're going to just pay out on a claim when we've got

0:42:40 > 0:42:44evidence to suggest that this person is not being completely honest.

0:42:48 > 0:42:52Insurance fraud in this country costs all of us money, but the days

0:42:52 > 0:42:55of no-questions-asked pay-outs are numbered.

0:42:55 > 0:42:59Insurers are using ever-more sophisticated technology to identify,

0:42:59 > 0:43:04track and prosecute fraudsters, and courts are using new powers to put

0:43:04 > 0:43:07these criminals behind bars.