0:00:06 > 0:00:09Insurance fraud in the UK has hit epidemic levels.
0:00:09 > 0:00:14It's costing us more than £1.3 billion every year.
0:00:14 > 0:00:17That's almost £3.6 million every day.
0:00:19 > 0:00:24Deliberate 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 > 0:00:43That's the subject out of the vehicle.
0:00:43 > 0:00:47..sophisticated data analysis techniques...
0:00:47 > 0:00:48Police!
0:00:48 > 0:00:51..and a number of highly skilled police units...
0:00:51 > 0:00:53Police! Stay where you are!
0:00:53 > 0:00:55..they're catching the criminals red-handed.
0:00:55 > 0:00:57Just don't lie to us.
0:00:57 > 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.
0:01:10 > 0:01:14Today, a motorist is caught red-handed when he tries to claim for the same
0:01:14 > 0:01:16damage twice.
0:01:16 > 0:01:20The evidence that we found in relation to the seat belt is irrefutable.
0:01:20 > 0:01:22When it's locked in position,
0:01:22 > 0:01:24it is locked and that's the end of the matter.
0:01:24 > 0:01:29A claimant comes clean after a dirty attempt to deceive her insurers.
0:01:38 > 0:01:42And a holiday-maker is caught trying to use her travel insurance policy
0:01:42 > 0:01:44to fund a makeover.
0:01:44 > 0:01:48There was clear discrepancies with what she'd told us had happened to what
0:01:48 > 0:01:50actually had happened.
0:01:54 > 0:01:55Now for a car owner,
0:01:55 > 0:02:00how frustrating is it when you return to your car only to discover that
0:02:00 > 0:02:03someone somehow has scratched it?
0:02:03 > 0:02:07Well, whether the damage is great or small, in a situation like that,
0:02:07 > 0:02:11you'd hope the other party would have the decency to leave their details.
0:02:11 > 0:02:14But, unfortunately, that isn't always case.
0:02:16 > 0:02:19Collisions with a parked car take place perhaps more often than you'd
0:02:19 > 0:02:21think. And when they do,
0:02:21 > 0:02:24an insurance policy is there to protect the innocent party.
0:02:27 > 0:02:30Insurers Admiral are well versed in dealing with claims relating to
0:02:30 > 0:02:34vehicles that have been involved in accidents and recently had a call with
0:02:34 > 0:02:39a man who alleged his car had been the victim of a bump in the night.
0:02:40 > 0:02:45We had a claim from a policy owner on the phone for the damage to his
0:02:45 > 0:02:52Mercedes-Benz. It was supposedly hit whilst parked by another vehicle.
0:03:28 > 0:03:30The man can't have been pleased to have returned to his car
0:03:30 > 0:03:33and found it so badly damaged.
0:03:33 > 0:03:36The only consolation was that he hadn't been in it
0:03:36 > 0:03:37at the time of the collision.
0:03:39 > 0:03:45The claim was worth about £25,500 in relation to the damage that was
0:03:45 > 0:03:49caused to the car, which rendered the car a write-off.
0:03:49 > 0:03:53So, a pretty hefty claim - but as the car was so badly damaged,
0:03:53 > 0:03:56it wasn't even driveable, nothing seemed untoward.
0:03:58 > 0:03:59When the claim came into us,
0:03:59 > 0:04:04it seemed perfectly genuine and we looked at it and decided that it was
0:04:04 > 0:04:08one that we needed to fast-track through to payment.
0:04:08 > 0:04:11But when Admiral began to process the claim,
0:04:11 > 0:04:14it quickly became apparent that it was anything but genuine.
0:04:16 > 0:04:19We had the vehicle examined to see...
0:04:19 > 0:04:22to have a look at the damage to the vehicle.
0:04:22 > 0:04:27And we also checked the online database that we have, to find out
0:04:27 > 0:04:32the history of the vehicle and what's happened to the car during its life.
0:04:32 > 0:04:33When Admiral checked,
0:04:33 > 0:04:38we found that the Mercedes-Benz that we were being asked to repair was
0:04:38 > 0:04:41actually logged as a previous write-off.
0:04:41 > 0:04:45Now, if the car had been written off in a previous accident, then how could
0:04:45 > 0:04:48it possibly have been involved in another crash?
0:04:50 > 0:04:53Admiral had hit a brick wall with the claim.
0:04:54 > 0:04:58So they turned to a forensic engineer to inspect the damage and see
0:04:58 > 0:05:01whether it matched the policy holder's version of events.
0:05:01 > 0:05:04In the initial instance, we were sent a number of photographs,
0:05:04 > 0:05:09very limited photographs, really, from the assessor who went to value it.
0:05:09 > 0:05:12And it was our initial examination of those images
0:05:12 > 0:05:15that set the alarm bells ringing for us, really.
0:05:15 > 0:05:17We didn't feel that it supported the claimant's case.
0:05:17 > 0:05:21The man had alleged that his vehicle had been hit while it was parked in
0:05:21 > 0:05:25a lay-by. But the photos told a very different story.
0:05:25 > 0:05:29The image of the front of the Mercedes shows that there's considerable
0:05:29 > 0:05:33frontal damage - and I mean considerable, this wasn't a bit of a bump,
0:05:33 > 0:05:36this was a hefty collision.
0:05:36 > 0:05:41We were able to determine from that that actually the impact came from
0:05:41 > 0:05:46the driver's side at an angle of about 45 degrees so, in other words,
0:05:46 > 0:05:49if the vehicle was parked up in a lay-by,
0:05:49 > 0:05:52then this was a very unusual collision because of the angle
0:05:52 > 0:05:54that it would have had to have been hit by.
0:05:55 > 0:05:59It seemed highly unlikely that the damage had occurred in the way the man
0:05:59 > 0:06:03had described. But to find out exactly what had happened,
0:06:03 > 0:06:06the engineers needed to see the damaged car for themselves.
0:06:08 > 0:06:09When the vehicle was examined,
0:06:09 > 0:06:13we found that the driver's seat belt was locked.
0:06:13 > 0:06:17And there were friction burns upon the webbing of the seat belt which
0:06:17 > 0:06:24indicated that, at the time of this collision, the vehicle was being driven.
0:06:24 > 0:06:28The evidence that we found in relation to the seat belt is irrefutable.
0:06:28 > 0:06:33It's how it works, the seat-belt tensioner is fired milliseconds before
0:06:33 > 0:06:35the airbag goes off.
0:06:35 > 0:06:37When it's locked in position,
0:06:37 > 0:06:39it is locked and that is the end of the matter.
0:06:39 > 0:06:43So, not only did it seem unlikely that the car had been parked in a
0:06:43 > 0:06:48lay-by, but now investigators had concrete evidence that it was actually
0:06:48 > 0:06:51being driven at the time of the crash.
0:06:51 > 0:06:54And that wasn't all they discovered.
0:06:54 > 0:06:59The front of the Mercedes contained evidence of concrete or brick dust
0:06:59 > 0:07:05or stone or something similar and traces of wood, so it was clear that this
0:07:05 > 0:07:10Mercedes had in fact crashed through a wall and collided with either a
0:07:10 > 0:07:12tree or some other wooden feature.
0:07:14 > 0:07:18The truth had been uncovered and this was clearly an attempt to submit
0:07:18 > 0:07:20a fraudulent claim.
0:07:20 > 0:07:24Not only that, but he was trying to claim for the same accident twice.
0:07:26 > 0:07:30As far as Admiral were concerned, there was only one option.
0:07:30 > 0:07:32Once we got all the evidence together,
0:07:32 > 0:07:35we told him that we would not be dealing with his claim because we
0:07:35 > 0:07:38believed that it was fraudulent
0:07:38 > 0:07:42and that a repudiation letter was on its way.
0:08:15 > 0:08:18I wouldn't say that the phone call would've been what we would've
0:08:18 > 0:08:21expected. If the claim had been genuine,
0:08:21 > 0:08:26he would've been very annoyed that we'd repudiated the claim so we did
0:08:26 > 0:08:31think the reaction that we had probably confirmed that we were right in
0:08:31 > 0:08:34our suspicions that the claim was fraudulent.
0:08:35 > 0:08:38The claim had been stopped, but Admiral needed to ensure
0:08:38 > 0:08:40this didn't happen again.
0:08:40 > 0:08:44We took it to the Insurance Fraud Enforcement Department
0:08:44 > 0:08:47and he was subsequently given a caution.
0:08:47 > 0:08:51By attempting to claim compensation money that he simply wasn't entitled
0:08:51 > 0:08:55to, this man now has a criminal record.
0:08:55 > 0:08:59In these situations, honesty is definitely the best policy.
0:08:59 > 0:09:02Be honest with your insurers because we do have the
0:09:02 > 0:09:04Insurance Fraud Enforcement Department
0:09:04 > 0:09:07sitting there, should we find a fraudulent claim and
0:09:07 > 0:09:10they will help us with the prosecution.
0:09:16 > 0:09:21Later, a large-scale bogus injury scam is scuppered as the claimants fail
0:09:21 > 0:09:23to clock the CCTV cameras.
0:09:23 > 0:09:26Very interesting that the bus driver was adamant that the two women who
0:09:26 > 0:09:29were claiming personal injury weren't even in the car at the time,
0:09:29 > 0:09:31the car was stationary, parked,
0:09:31 > 0:09:34unattended and they weren't anywhere near it.
0:09:34 > 0:09:39A serial fraudster's bogus burglary claims are busted when greed gets
0:09:39 > 0:09:40the better of him.
0:09:40 > 0:09:45We found that some of the items allegedly stolen during the course of the
0:09:45 > 0:09:51recent burglary were also featured in the previous linked claims.
0:09:55 > 0:09:58Insurance companies have heard it all when it comes to claims for
0:09:58 > 0:10:03compensation, but, as far-fetched as many genuine claims might sound,
0:10:03 > 0:10:07the golden rule is to always tell the truth because if you don't,
0:10:07 > 0:10:11then not only could it invalidate your policy but it could also land you
0:10:11 > 0:10:14with a criminal conviction for fraud.
0:10:17 > 0:10:20With nearly everyone in the UK owning a mobile phone,
0:10:20 > 0:10:25specific policies covering phone loss and theft are becoming more and more common.
0:10:27 > 0:10:31Insurance company Assurant offer cover for some of the UK's top
0:10:31 > 0:10:32mobile phone providers.
0:10:34 > 0:10:38They recently received a call from a customer who wanted to make a claim
0:10:38 > 0:10:39on her policy.
0:10:40 > 0:10:44So, this particular claimant was claiming for a high-end Samsung device
0:10:44 > 0:10:47valued at about £350.
0:11:23 > 0:11:28It's fair to say that the claimant wasn't too happy about her loss.
0:11:28 > 0:11:32Whilst it's not unusual for a lot of our customers to drop their handsets
0:11:32 > 0:11:36in the toilet, what's really unusual about this case is the claimant said
0:11:36 > 0:11:42that they'd lost the handset and it was flushed away through the system.
0:11:42 > 0:11:45Although her story sounded a bit dodgy,
0:11:45 > 0:11:49the insurance company were prepared to give her the benefit of the doubt.
0:11:49 > 0:11:54Upon receiving the circumstances of this particular claim,
0:11:54 > 0:11:57our agent asked verification questions,
0:11:57 > 0:12:03where this particular claimant offered to send in photographs of the
0:12:03 > 0:12:08particular toilet, which she claimed was a bog-standard toilet.
0:12:08 > 0:12:14The customer duly sent in these rather fetching photos of the toilet in
0:12:14 > 0:12:19question. It might not be the cleanest of facilities but she was right
0:12:19 > 0:12:22about it being bog-standard.
0:12:22 > 0:12:25The insurance team then needed to know if it was physically possible
0:12:25 > 0:12:28for the phone to disappear down the toilet.
0:12:28 > 0:12:31And when they looked into the likelihood of that happening,
0:12:31 > 0:12:34they reached a unanimous verdict.
0:12:34 > 0:12:39Our investigations uncovered that it was physically impossible for
0:12:39 > 0:12:45a 14cm phone to be flushed through an 11 centimetre piping
0:12:45 > 0:12:47which had a u-bend in it.
0:12:48 > 0:12:52Now, I can't say I envy the person testing that claim out but there was
0:12:52 > 0:12:57no denying that this customer's story was fast going down the pan.
0:12:58 > 0:13:02Assurant than phoned the woman to give her another chance to come clean.
0:13:36 > 0:13:40It looked like this chancer was sticking to her story so the
0:13:40 > 0:13:43insurance company decided to set her straight.
0:15:10 > 0:15:14The truth had finally been flushed out and the woman was incredibly
0:15:14 > 0:15:19fortunate the matter hadn't been taken any further.
0:15:19 > 0:15:23If she had've continued with the original story,
0:15:23 > 0:15:28we would've declined the claim and this particular claimant would've been
0:15:28 > 0:15:34identified as a future potential fraudster for providing misleading
0:15:34 > 0:15:36information to us.
0:15:36 > 0:15:41This was a case of attempted fraud that wasn't even necessary.
0:15:41 > 0:15:45What's unusual about this claimant is she had a valid claim,
0:15:45 > 0:15:47she should've just claimed and stuck to the facts.
0:15:47 > 0:15:50She didn't need to make up a story.
0:15:50 > 0:15:51By lying to her insurer,
0:15:51 > 0:15:55the woman could've easily ended up empty-handed or, worse still,
0:15:55 > 0:16:00with a caution or even a conviction for insurance fraud.
0:16:00 > 0:16:05Fraud costs the UK insurance industry nearly £200 billion and just to put
0:16:05 > 0:16:07into that context,
0:16:07 > 0:16:11that's nearly £3,000 for every one of us living in the UK and that's why
0:16:11 > 0:16:16it's vital as a firm and as an industry we detect and stop fraud.
0:16:21 > 0:16:26Coming home to discover that you've been burgled is a horrible feeling.
0:16:26 > 0:16:29In addition to the loss of your most valuable and sentimental possessions,
0:16:29 > 0:16:33the experience can leave you feeling vulnerable in your own home,
0:16:33 > 0:16:37knowing that a stranger has been in there, rummaging through your lives.
0:16:37 > 0:16:40Now, although it can't take away the unpleasantness of a break-in,
0:16:40 > 0:16:44a home contents insurance policy can help us to get back on our feet by
0:16:44 > 0:16:48covering the cost of the possessions that can be replaced.
0:16:53 > 0:16:56But there are some people who see these policies as a quick way of making
0:16:56 > 0:16:57a few quid.
0:16:59 > 0:17:02RSA is an insurance company that provides cover for our personal
0:17:02 > 0:17:06belongings should the worst happen and recently dealt with a case
0:17:06 > 0:17:07involving a burglary.
0:17:10 > 0:17:17This was a claim we had from our customer, a Mr Solomon Lahr.
0:17:18 > 0:17:25He had apparently had a burglary and he'd suffered various loss of items
0:17:25 > 0:17:31in the burglary to the value of about £6,000.
0:17:31 > 0:17:32As with many burglaries,
0:17:32 > 0:17:35the things that had been stolen were mostly jewellery and electrical
0:17:35 > 0:17:38items. As far as RSA were concerned,
0:17:38 > 0:17:42it was a routine claim and promptly began the process of getting their
0:17:42 > 0:17:44policy holder back on his feet.
0:17:44 > 0:17:52Mr Lahr produced to us a number of boxes and receipts from the items which
0:17:52 > 0:17:57were allegedly stolen and the actual break-in was witnessed by a passer-by.
0:17:57 > 0:18:02But because he was claiming for high-value goods, RSA decided to
0:18:02 > 0:18:04pay Mr Lahr visit.
0:18:04 > 0:18:08But, in doing so, they came across a rather alarming fact.
0:18:10 > 0:18:13When we visited the premises,
0:18:13 > 0:18:16bearing in mind that the break-in had allegedly been spotted by a
0:18:16 > 0:18:22passer-by, we found that the window through which access was gained,
0:18:22 > 0:18:26which was now boarded up, was at the rear of the premises,
0:18:26 > 0:18:30so it would've been physically impossible for a passer-by from the street
0:18:30 > 0:18:33to have witnessed the event,
0:18:33 > 0:18:37unless they'd actually been in the garden of the property.
0:18:38 > 0:18:43Unsurprisingly, this revelation immediately raised concerns
0:18:43 > 0:18:46and it wasn't long before RSA uncovered more evidence
0:18:46 > 0:18:50that suggested this wasn't your average burglary.
0:18:50 > 0:18:56We also noticed through our automated fraud detection machinery
0:18:56 > 0:19:02some links between this claim and several other claims
0:19:02 > 0:19:05in different names and at different addresses.
0:19:05 > 0:19:08When we looked into the claims that were linked,
0:19:08 > 0:19:13we found the mobile telephone numbers matched and indeed we found that
0:19:13 > 0:19:18some of the items allegedly stolen during the course of the recent
0:19:18 > 0:19:23burglary were also featured in the previous linked claims.
0:19:24 > 0:19:27With all of the evidence leading back to Mr Lahr,
0:19:27 > 0:19:31it was crystal clear he had been submitting claim after claim under
0:19:31 > 0:19:32different aliases.
0:19:33 > 0:19:37RSA then turned their attention to the other claims Mr Lahr was linked to.
0:19:40 > 0:19:43Ultimately, we found nine claims
0:19:43 > 0:19:47all linked by various factors spread over
0:19:47 > 0:19:53a period of time and we thought this was a deliberate and persistent set
0:19:53 > 0:19:58of dishonest claims that had been presented by this gentleman.
0:19:58 > 0:19:59But unfortunately for Mr Lahr,
0:19:59 > 0:20:04he wasn't able to keep track of his numerous identities and eventually
0:20:04 > 0:20:06slipped up.
0:20:06 > 0:20:11There was one incident where actually he rather forgot his own aliases and
0:20:11 > 0:20:16in chasing us up for progress on his latest claim as Mr Lahr,
0:20:16 > 0:20:19he actually used the same e-mail
0:20:19 > 0:20:22he'd sent to us on another claim under a different name.
0:20:22 > 0:20:26With the total of these claims amounting to thousands of
0:20:26 > 0:20:30pounds, RSA decided to refer the case to the City of London Police's
0:20:30 > 0:20:34Insurance Fraud Enforcement Department for further investigation.
0:20:38 > 0:20:42IFED soon discovered the full extent of this fraudster's crimes
0:20:42 > 0:20:44and it's fair to say he'd been busy.
0:20:45 > 0:20:47IFED'S investigation established
0:20:47 > 0:20:50that this gentleman's true name was
0:20:50 > 0:20:53a Mr Ugwu.
0:20:53 > 0:20:59He had, in addition to the nine claims he had pursued against RSA using
0:20:59 > 0:21:00various aliases,
0:21:00 > 0:21:06he had also pursued 22 other claims against other insurers,
0:21:06 > 0:21:09again using different aliases.
0:21:09 > 0:21:15So, this gentleman invented essentially 31 separate claims
0:21:15 > 0:21:17across a number of insurers
0:21:19 > 0:21:24and this was a very persistent and widespread fraud.
0:21:26 > 0:21:30Mr Ugwu was arrested at his home address, where officers found yet more
0:21:30 > 0:21:32damning evidence.
0:21:33 > 0:21:38They found a number of items there related to the series of claims that
0:21:38 > 0:21:44he'd made, including equipment for producing fraudulent receipts
0:21:44 > 0:21:47and his fingerprints were over a number of related documents
0:21:47 > 0:21:51across all of the claims that he had made.
0:21:52 > 0:21:55Mr Ugwu was clearly a serial fraudster.
0:21:55 > 0:21:58His claims were all planned, albeit carelessly,
0:21:58 > 0:22:03in an attempt to cash in - but ultimately his sloppiness and greed had been
0:22:03 > 0:22:04his undoing.
0:22:06 > 0:22:12He was charged and appeared at Bolton Crown Court where he pleaded guilty
0:22:12 > 0:22:18and I think he was extremely fortunate to receive a six-month
0:22:18 > 0:22:22prison sentence, suspended for two years.
0:22:22 > 0:22:27He was also ordered to do 60 hours unpaid community work and from our
0:22:27 > 0:22:34perspective, he was ordered to pay back the £3,700 that we had paid to him
0:22:34 > 0:22:38on two of the claims that he had pursued with us.
0:22:40 > 0:22:44It was a clear message to anyone who thinks insurance policies are an
0:22:44 > 0:22:46easy way to cash in.
0:22:47 > 0:22:50I think in the past, people might have thought insurers
0:22:50 > 0:22:51were a soft touch
0:22:51 > 0:22:54and you could get away with this type of behaviour,
0:22:54 > 0:22:59but we now use quite sophisticated technology
0:22:59 > 0:23:01to spot this type of activity.
0:23:01 > 0:23:04You will be caught and if you are caught,
0:23:04 > 0:23:07then the consequences to you can be quite dire.
0:23:13 > 0:23:17It's an added expense that none of us particularly enjoys paying,
0:23:17 > 0:23:22but, for peace of mind, a travel insurance policy is a holiday essential.
0:23:22 > 0:23:24However, just like any other type of insurance,
0:23:24 > 0:23:26there are terms and conditions.
0:23:26 > 0:23:30And whether it's a case of lost luggage or a medical emergency,
0:23:30 > 0:23:34you need to be aware of exactly what your policy does and does not cover.
0:23:37 > 0:23:41Collinson Group offer many different insurance products,
0:23:41 > 0:23:43from personal accident to car and home emergency,
0:23:43 > 0:23:45and recently received a call from a woman
0:23:45 > 0:23:48who wanted to claim on her travel policy.
0:23:51 > 0:23:55The claim originally submitted to us was for medical expenses incurred
0:23:55 > 0:23:56whilst on holiday in India.
0:24:05 > 0:24:09Our insured had claimed that she had a tooth extracted due to an immense pain
0:24:09 > 0:24:11she was receiving in one of her teeth.
0:24:37 > 0:24:43It sounded like the holiday from hell but her ordeal only got worse.
0:24:44 > 0:24:45Whilst in hospital,
0:24:45 > 0:24:50she unfortunately contracted a very bad chest infection so, all in all,
0:24:50 > 0:24:53this lady was having a very bad time of it.
0:24:53 > 0:24:57The woman claimed she had spent three days in hospital amounting to a bill
0:24:57 > 0:24:59of around £1,000.
0:25:00 > 0:25:02Upon receipt of the claim from our policy holder,
0:25:02 > 0:25:05all the documentation received appeared genuine.
0:25:05 > 0:25:08She'd sent as all the relevant receipts from the dentist.
0:25:08 > 0:25:11She'd sent her submission and discharge notes from the hospital and proof of
0:25:11 > 0:25:13payment to both facilities.
0:25:13 > 0:25:18With all the boxes ticked, everything appeared to be above board.
0:25:18 > 0:25:20But, on closer inspection of the documents,
0:25:20 > 0:25:24the legitimacy of the entire claim was thrown into doubt.
0:25:24 > 0:25:27After we received a medical report from our policy holder,
0:25:27 > 0:25:31there was clear discrepancies with what she had told us had happened to
0:25:31 > 0:25:33what actually had happened.
0:25:33 > 0:25:38The doctor has written that she had actually had bilateral implants done
0:25:38 > 0:25:40the previous day.
0:25:40 > 0:25:44It was an allergic reaction to the medicine taken for this as the reason
0:25:44 > 0:25:46why she presented herself to hospital.
0:25:47 > 0:25:51The woman had originally said the medicine she reacted to was pain relief
0:25:51 > 0:25:53for an emergency tooth extraction,
0:25:53 > 0:25:56rather than any form of dental implant surgery.
0:25:57 > 0:25:59With the circumstances of the claim looking suspicious,
0:25:59 > 0:26:02it was referred to the fraud department, who instructed an overseas
0:26:02 > 0:26:05investigator to look into the case.
0:26:07 > 0:26:10His findings shed a bit more light on what exactly had happened.
0:26:13 > 0:26:17Our fraud investigation team actually found out that she had had previous
0:26:17 > 0:26:20treatment a year before but, due to time constraints,
0:26:20 > 0:26:23she was asked to come back a year later.
0:26:23 > 0:26:26It was at this point that the tooth that was meant to be fixed had
0:26:26 > 0:26:30actually created an infection and it was an allergic reaction to the
0:26:30 > 0:26:35medicine that he gave her that made her visit the hospital with all these
0:26:35 > 0:26:38terrible things that she told us over the phone.
0:26:39 > 0:26:42As the hospital visit was a result of planned treatment,
0:26:42 > 0:26:46the woman wasn't covered under her travel insurance policy.
0:26:46 > 0:26:49Once we'd received all the information, we made contact with the insured
0:26:49 > 0:26:54via a letter. It basically said to her that she had attempted to claim for
0:26:54 > 0:26:59medical expenses - however, it was clear that this was, in no way,
0:26:59 > 0:27:01a medical emergency.
0:27:02 > 0:27:05This claim was 100% pre-planned,
0:27:05 > 0:27:09pre-existing and her claim was declined accordingly.
0:27:11 > 0:27:14It was a great result for Collinson Group in their ongoing fight against
0:27:14 > 0:27:20fraud and is a valuable reminder that insurance policies are not blanket
0:27:20 > 0:27:23cover and will only pay out on the claims that they are specifically
0:27:23 > 0:27:25intended for.
0:27:25 > 0:27:28Some people believe that a travel insurance product is actually a
0:27:28 > 0:27:30private medical policy.
0:27:30 > 0:27:35It isn't. It is for unplanned and medical emergencies and needs to be
0:27:35 > 0:27:36treated that way.
0:27:42 > 0:27:46Still to come... A dog breeder can't get her facts straight.
0:28:04 > 0:28:06Now, as this series aims to demonstrate,
0:28:06 > 0:28:10fraudulent insurance claims aren't always as straightforward to detect
0:28:10 > 0:28:12as you might think. And, in fact,
0:28:12 > 0:28:17cracking some cases can take months or even years of investigation,
0:28:17 > 0:28:19but when it comes to sorting the wheat from the chaff,
0:28:19 > 0:28:23there's one source of evidence almost never fails.
0:28:26 > 0:28:30CCTV cameras are part of public furniture pretty much everywhere we go
0:28:30 > 0:28:32these days.
0:28:33 > 0:28:37Whether it be on public transport, in shops or car parks,
0:28:37 > 0:28:40more often than not, all angles are covered.
0:28:41 > 0:28:46These all-seeing eyes can be crucial in the fight against insurance fraud.
0:28:47 > 0:28:50Zurich recently dealt with a claim resulting from an incident that
0:28:50 > 0:28:52happened between a bus and a parked car.
0:28:55 > 0:28:58We insure a bus company and we received a claim suggesting that one of
0:28:58 > 0:29:00their buses, whilst driving along...
0:29:03 > 0:29:05The engine hatch had become open.
0:29:05 > 0:29:09A passer-by had notified that to the driver and then the driver was then
0:29:09 > 0:29:13approached by a woman suggesting that the bus had actually collided with
0:29:13 > 0:29:14her vehicle.
0:29:15 > 0:29:19The woman alleged that the engine hatch had caught the near side
0:29:19 > 0:29:23of her parked car and was claiming for damage to the vehicle.
0:29:23 > 0:29:25Initially, it seemed like a straightforward case.
0:29:26 > 0:29:29We thought, at that point, we would repair the vehicle or pay for the
0:29:29 > 0:29:32repairs to the vehicle and that would be the end of the claim.
0:29:32 > 0:29:35However, what transpired was that we actually received a personal injury
0:29:35 > 0:29:39claim from the owner of the vehicle, who suggested that when the bus
0:29:39 > 0:29:42collided with her she was thrown about the car.
0:29:42 > 0:29:45Not only that, we also got a personal injury claim from her mother, who was
0:29:45 > 0:29:49also suggesting she was in the vehicle at the time.
0:29:49 > 0:29:52The injuries were the classic whiplash-type soft tissue injuries that we
0:29:52 > 0:29:55see a lot in claims of this nature.
0:29:55 > 0:29:59Zurich became suspicious as the injury claim was submitted several weeks
0:29:59 > 0:30:05after the damage claim and hadn't been mentioned at all in previous conversations.
0:30:06 > 0:30:08Once we got the personal injury claim,
0:30:08 > 0:30:12we were very keen to establish exactly what information our policy holder had -
0:30:12 > 0:30:17because clearly he was on the scene and he could say exactly what had happened.
0:30:17 > 0:30:19But when they spoke to the bus company,
0:30:19 > 0:30:22a very different story emerged.
0:30:22 > 0:30:25Well, very interestingly, the bus driver was adamant that the two women
0:30:25 > 0:30:28who were claiming personal injury weren't even in the car at the time.
0:30:28 > 0:30:30The car was stationary, parked,
0:30:30 > 0:30:34unattended and they were not anywhere near it.
0:30:34 > 0:30:37So if they weren't actually sitting in the vehicle how could they have
0:30:37 > 0:30:39been injured?
0:30:39 > 0:30:44Luckily, the bus was fitted with multiple CCTV cameras that had recorded
0:30:44 > 0:30:46the whole thing.
0:30:46 > 0:30:51We managed to secure CCTV footage from the bus, which was crucial,
0:30:51 > 0:30:52because this type of footage provides you
0:30:52 > 0:30:56with categoric insight in terms of what happened.
0:30:56 > 0:31:00The recording clearly shows the bus approaching the parked car
0:31:00 > 0:31:01on the left.
0:31:03 > 0:31:06Then a passer-by signalling to the bus driver,
0:31:06 > 0:31:08telling him that his engine hatch is open.
0:31:10 > 0:31:14But, above all else, one thing stuck out like a sore thumb.
0:31:20 > 0:31:23So what is clear in the footage is that the woman was definitely
0:31:23 > 0:31:26outside the vehicle at the time of the alleged collision.
0:31:32 > 0:31:34Well, not only was she not in the vehicle,
0:31:34 > 0:31:37she's not sustained any injury whatsoever as a result of this incident,
0:31:37 > 0:31:40so it was a complete fabrication.
0:31:42 > 0:31:45It's unclear, in terms of the image of the passenger seat,
0:31:45 > 0:31:48but we subsequently learned through the footage that the other woman
0:31:48 > 0:31:51- wasn't in the car either. - By closely watching the footage,
0:31:51 > 0:31:55investigators could see that the damage the woman claimed had been done to
0:31:55 > 0:31:58her car was also completely made up,
0:31:58 > 0:32:01as it was clearly visible before the bus
0:32:01 > 0:32:03had come into contact with the car.
0:32:03 > 0:32:07Zurich knew exactly what was going on here.
0:32:08 > 0:32:10Once we had the CCTV footage,
0:32:10 > 0:32:12and we could prove that these women weren't in the car,
0:32:12 > 0:32:14then the claims were clearly repudiated.
0:32:14 > 0:32:16There was no way we were going to pay them
0:32:16 > 0:32:18and we referred the case to IFED.
0:32:20 > 0:32:25IFED is the City of London Police's Insurance Fraud Enforcement Department.
0:32:25 > 0:32:29IFED's investigations reaffirmed the fact that these two women weren't in
0:32:29 > 0:32:31the car and, when questioned,
0:32:31 > 0:32:34they both admitted that and received cautions as a result.
0:32:35 > 0:32:38We were really pleased with the outcome because it shows that somebody who
0:32:38 > 0:32:43brazenly attempts to claim personal injury for an incident they're not
0:32:43 > 0:32:46entitled to should expect to receive justice.
0:32:46 > 0:32:49Now with criminal records to their names,
0:32:49 > 0:32:52these women learned first-hand that the days of personal injury claims
0:32:52 > 0:32:55providing a means to easy money are long gone.
0:32:58 > 0:33:03It still surprises me that in this day and age, where there is CCTV footage
0:33:03 > 0:33:06all over the place, particularly in public transport,
0:33:06 > 0:33:09that they think they can get away with submitting personal injury claims
0:33:09 > 0:33:12in situations that were just fabricated.
0:33:17 > 0:33:19As any dog owner will tell you,
0:33:19 > 0:33:24bringing home a new puppy can be an exciting but stressful experience.
0:33:24 > 0:33:26With the chewing and the training and everything else,
0:33:26 > 0:33:31a pet insurance policy is probably the last thing on an owner's mind
0:33:31 > 0:33:36but should disaster strike when cover isn't in place, vets fees can burn
0:33:36 > 0:33:38a very big hole in our pockets.
0:33:38 > 0:33:42Fortunately, there are policies out there specifically designed for those
0:33:42 > 0:33:47first few weeks as owners find their feet with their new companions.
0:33:49 > 0:33:53Some companies offer dog breeder insurance policies.
0:33:53 > 0:33:56These are taken out by the breeder then transferred to the new owner
0:33:56 > 0:33:58when the puppy is sold.
0:33:58 > 0:34:01The breeder has a grace period from the date of sale to activate the
0:34:01 > 0:34:06policy, but, until they do so, the pup won't be covered.
0:34:06 > 0:34:12Agria insure over 100,000 pets and know just how useful pet insurance
0:34:12 > 0:34:14can be when a pup gets sick.
0:34:14 > 0:34:17They recently had a case where a breeder wanted to take out an insurance
0:34:17 > 0:34:21policy for a puppy she'd sold a few days previously.
0:34:23 > 0:34:27We received a call from the breeder insuring a French Bulldog puppy,
0:34:27 > 0:34:29a little boy puppy.
0:34:31 > 0:34:34When she called, the breeder was in a bit of a fluster.
0:36:08 > 0:36:12So the policy had been set up and it had been made clear to the breeder
0:36:12 > 0:36:15that it didn't cover any pre-existing issues.
0:36:17 > 0:36:20But, as the breeder had ended the call by saying all was OK with the
0:36:20 > 0:36:24puppy, presumably that wasn't a problem.
0:36:24 > 0:36:2730 minutes after the policy was set up by the breeder,
0:36:27 > 0:36:30we received another telephone call from the same number
0:36:30 > 0:36:36from a person who didn't identify herself but posed some hypothetical questions to us.
0:37:11 > 0:37:13Although the woman didn't give her name,
0:37:13 > 0:37:17the suspiciously similar voice combined with the same telephone number
0:37:17 > 0:37:21strongly suggested that this was the same person.
0:37:21 > 0:37:25There are no prizes for guessing what happened next.
0:37:25 > 0:37:28The very next day, we received a telephone call from the policy holder,
0:37:28 > 0:37:32the new puppy owner, who said, believe it or not,
0:37:32 > 0:37:35we've got to make a claim already.
0:37:35 > 0:37:39The very small French Bulldog puppy had been attacked by a very large
0:37:39 > 0:37:44German Shepherd dog and had sustained serious bite wounds.
0:37:45 > 0:37:50The puppy's new owner was claiming over £1,800 for treatment it received
0:37:50 > 0:37:51at the vets the previous day.
0:37:51 > 0:37:55But, before they could pay their claim, Agria
0:37:55 > 0:37:59needed to establish exactly when the incident had happened.
0:37:59 > 0:38:04So they contacted the vets to see if it was before or after the policy had been set up.
0:38:04 > 0:38:08So when we got the veterinary history back, we looked at that in
0:38:08 > 0:38:11detail and it was very precise about what had happened,
0:38:11 > 0:38:15so the animal was seen on the same day that the policy was set up.
0:38:15 > 0:38:18The animal was taken into the practice at 3:30,
0:38:18 > 0:38:20seen by a vet at four o'clock and then,
0:38:20 > 0:38:24when we compare that to our system records,
0:38:24 > 0:38:29the policy wasn't set up until about an hour and a half later, at 5:30.
0:38:30 > 0:38:34It was crystal clear that the breeder had incepted the policy after the
0:38:34 > 0:38:37incident had happened,
0:38:37 > 0:38:40meaning the owner wasn't covered for the £1,800 bill.
0:38:41 > 0:38:46Agria called the breeder and gave her one last chance to get her facts straight.
0:39:59 > 0:40:03This sounds like a classic case of avoiding the question.
0:40:03 > 0:40:06Perhaps she'd do better when answering the next one.
0:40:06 > 0:40:10We then went on in the phone call to question the breeder about her statement,
0:40:10 > 0:40:15very early on when she activated the insurance, that the puppy had had a
0:40:15 > 0:40:17problem, had had an incident,
0:40:17 > 0:40:20and something had happened to the puppy and we asked her what that was
0:40:20 > 0:40:22and why she said that.
0:40:45 > 0:40:47That's not what she said on the original call.
0:40:57 > 0:41:01At this point, Agri had heard enough of the woman leading them on.
0:41:28 > 0:41:32So the breeder had sold the puppy but had forgotten to activate the free
0:41:32 > 0:41:35five-week policy that's offered to new owners.
0:41:35 > 0:41:37The puppy had then been attacked.
0:41:37 > 0:41:39The new owners had taken her to the vet and
0:41:39 > 0:41:43subsequently asked the breeder for the policy details to cover the cost
0:41:43 > 0:41:48of the treatment. It was at that point the breeder had called Agria
0:41:48 > 0:41:49to activate the cover,
0:41:49 > 0:41:53knowing full well that the puppy had already been attacked.
0:41:53 > 0:41:57But now they'd been found out and the puppy's new owners had become the
0:41:57 > 0:42:00victims, thanks to the breeder's incompetence.
0:42:02 > 0:42:07It seemed the breeder had nothing more to say and had finally admitted
0:42:07 > 0:42:09defeat. Sadly,
0:42:09 > 0:42:13it's the kind of story that Simon sees all too often and shows just how
0:42:13 > 0:42:17important it is for a new owner to make sure insurance has been properly
0:42:17 > 0:42:21set up by the breeder before a puppy is taken home.
0:42:23 > 0:42:26It's really important that we treat it as fraud and try and identify
0:42:26 > 0:42:29fraud and eradicate fraud from all of our processes.
0:42:29 > 0:42:33It's not good enough that something happens and then someone tries to
0:42:33 > 0:42:36insure against it. That's completely against the principle of insurance.
0:42:36 > 0:42:41You take out insurance against the probability of something happening
0:42:41 > 0:42:42in the future.
0:42:47 > 0:42:50From organised criminal gangs to exaggerated household claims,
0:42:50 > 0:42:54insurance fraud hits all of us in the pocket.
0:42:54 > 0:42:55But, instead of getting away with it,
0:42:55 > 0:42:59more and more of these fraudsters are being claimed and shamed.