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Insurance fraud in the UK has hit epidemic levels. | 0:00:06 | 0:00:10 | |
It's costing us more than £1.3 billion every year. | 0:00:10 | 0:00:14 | |
That's almost £3.6 million every day. | 0:00:14 | 0:00:17 | |
Deliberate crashes, bogus personal injuries, even phantom pets. | 0:00:19 | 0:00:24 | |
The fraudsters are risking more and more to make a quick killing, | 0:00:26 | 0:00:29 | |
and every year it's adding around £50 to your insurance bill. | 0:00:29 | 0:00:33 | |
But insurers are fighting back, | 0:00:33 | 0:00:36 | |
exposing just under 15 fake claims every hour. | 0:00:36 | 0:00:39 | |
Armed with covert surveillance systems... | 0:00:39 | 0:00:41 | |
That's the subject out the vehicle. | 0:00:41 | 0:00:44 | |
..sophisticated data analysis techniques... | 0:00:44 | 0:00:47 | |
Police! | 0:00:47 | 0:00:49 | |
..and a number of highly skilled police units... | 0:00:49 | 0:00:51 | |
Police, stand back! Stay where you are! | 0:00:51 | 0:00:53 | |
..they're catching the criminals red-handed. | 0:00:53 | 0:00:56 | |
Just don't lie to us. | 0:00:56 | 0:00:58 | |
All those con men, scammers and cheats on the fiddle | 0:00:58 | 0:01:01 | |
are now caught in the act and claimed and shamed. | 0:01:01 | 0:01:04 | |
A large-scale bogus injury scam is scuppered, | 0:01:11 | 0:01:14 | |
as the claimants fail to clock the CCTV cameras... | 0:01:14 | 0:01:17 | |
I think it's probably fair to assume that most or all of these | 0:01:19 | 0:01:22 | |
60 claimants thought that this would be a fairly easy ride | 0:01:22 | 0:01:26 | |
and that they would get some compensation reasonably quickly. | 0:01:26 | 0:01:30 | |
..social media is the undoing of a bride-to-be's claim | 0:01:30 | 0:01:33 | |
for a lost engagement ring... | 0:01:33 | 0:01:35 | |
..and a con artist is caught in the act when he tries to repeat | 0:01:44 | 0:01:47 | |
a previous claim. | 0:01:47 | 0:01:49 | |
The passer-by that witnessed the accident actually stopped | 0:01:49 | 0:01:51 | |
at the scene and informed us that he'd been involved | 0:01:51 | 0:01:55 | |
in a very similar accident at the same location | 0:01:55 | 0:01:57 | |
with the same third party only three months before. | 0:01:57 | 0:02:01 | |
Now, with the volume of traffic on the roads constantly on the up, | 0:02:06 | 0:02:09 | |
more and more of us are leaving our cars at home and turning | 0:02:09 | 0:02:12 | |
to public transport to get around. | 0:02:12 | 0:02:14 | |
But as convenient as it is sitting back and leaving | 0:02:14 | 0:02:17 | |
the stress of navigating the city streets to someone else, | 0:02:17 | 0:02:20 | |
taking to the roads always presents a risk, | 0:02:20 | 0:02:23 | |
even when there is a trained professional behind the wheel. | 0:02:23 | 0:02:26 | |
For many of us who live or work in built-up cities, | 0:02:33 | 0:02:36 | |
buses are the preferred mode of transport | 0:02:36 | 0:02:38 | |
and can often save us valuable time. | 0:02:38 | 0:02:41 | |
But just like any other vehicles, buses are susceptible to accidents, | 0:02:42 | 0:02:47 | |
and with up to 75 passengers on board at any one time, | 0:02:47 | 0:02:50 | |
that can generate a lot of personal injury claims. | 0:02:50 | 0:02:53 | |
With a fleet of over 6,000 buses, | 0:02:56 | 0:02:58 | |
First Group are no stranger to multiple claims, | 0:02:58 | 0:03:01 | |
but they recently dealt with one batch that turned out to be | 0:03:01 | 0:03:04 | |
the result of foul play. | 0:03:04 | 0:03:06 | |
One of our buses was involved in a very minor collision. | 0:03:09 | 0:03:12 | |
Our bus was travelling in slow-moving traffic | 0:03:12 | 0:03:14 | |
when the vehicle in front had to brake for amber traffic lights. | 0:03:14 | 0:03:18 | |
Unfortunately, our bus was a little too close and collided | 0:03:18 | 0:03:21 | |
with the rear of the Ford Fiesta. | 0:03:21 | 0:03:24 | |
The bus was full of football supporters on their way | 0:03:24 | 0:03:26 | |
to a Leeds United match, and the car contained an elderly couple. | 0:03:26 | 0:03:31 | |
Thankfully, the bus was travelling at less than 10mph | 0:03:31 | 0:03:34 | |
when the collision happened. | 0:03:34 | 0:03:36 | |
The incident itself was relatively minor. | 0:03:36 | 0:03:39 | |
There was scuffing to our bus and minor damage to the Ford Fiesta. | 0:03:39 | 0:03:43 | |
So, we dealt with the repairs to the Ford Fiesta | 0:03:43 | 0:03:46 | |
and that was the end of it. | 0:03:46 | 0:03:47 | |
Or so they thought. | 0:03:47 | 0:03:50 | |
Within days, we started receiving injury claims. | 0:03:50 | 0:03:53 | |
The first one or two, obviously suspicious, | 0:03:53 | 0:03:55 | |
because it was a very minor accident. | 0:03:55 | 0:03:57 | |
However, they kept coming and, within a few weeks, | 0:03:57 | 0:04:00 | |
we had over 40 claims. | 0:04:00 | 0:04:02 | |
On one day alone, we received 25 claims, | 0:04:02 | 0:04:05 | |
much to the dismay of the file handler on the case, | 0:04:05 | 0:04:08 | |
and then within six months we had 60 claims, which was absolutely absurd. | 0:04:08 | 0:04:12 | |
So, a minor rear-end shunt that had left an elderly couple in a tiny car | 0:04:14 | 0:04:19 | |
completely unscathed had resulted in a staggering number of claims | 0:04:19 | 0:04:23 | |
from the football supporters, | 0:04:23 | 0:04:25 | |
amounting to £500,000 | 0:04:25 | 0:04:27 | |
in injury compensation and legal costs. | 0:04:27 | 0:04:31 | |
And nearly every one of them was claiming the same thing. | 0:04:31 | 0:04:34 | |
We were not surprised to find that most of the claimants that were | 0:04:34 | 0:04:37 | |
pursuing the claims were claiming that they had soft tissue injuries, | 0:04:37 | 0:04:40 | |
but some of the claims that they were presenting to us | 0:04:40 | 0:04:43 | |
were completely absurd. | 0:04:43 | 0:04:45 | |
We had nightmares, flashbacks, we had fear of travel, | 0:04:46 | 0:04:50 | |
we had severe psychological trauma, | 0:04:50 | 0:04:52 | |
and probably the worst was the severe panic attacks | 0:04:52 | 0:04:55 | |
that one claimant allegedly suffered on a daily basis. | 0:04:55 | 0:04:58 | |
The list of injuries and ailments was simply astonishing. | 0:04:59 | 0:05:04 | |
So, First Group immediately launched a full investigation, | 0:05:04 | 0:05:07 | |
and it wasn't long before they discovered an alarming trend | 0:05:07 | 0:05:10 | |
with the claims. | 0:05:10 | 0:05:11 | |
One of the things we did find rather surprising is we had 60 claimants, | 0:05:12 | 0:05:16 | |
and 55 were represented by the same solicitor, which is highly unusual. | 0:05:16 | 0:05:21 | |
With a multiple claim, | 0:05:21 | 0:05:22 | |
you'd expect to see the individuals represented by | 0:05:22 | 0:05:26 | |
various different solicitors. | 0:05:26 | 0:05:28 | |
Suspecting they'd been the target of a large-scale attempt at fraud, | 0:05:28 | 0:05:32 | |
First Group stepped up their investigation | 0:05:32 | 0:05:35 | |
and turned to the CCTV footage recorded on the bus | 0:05:35 | 0:05:38 | |
at the time of the accident. | 0:05:38 | 0:05:40 | |
As expected, it clearly shows the bus following the Fiesta, | 0:05:41 | 0:05:45 | |
the Fiesta coming to a sharp halt at the traffic lights, | 0:05:45 | 0:05:48 | |
the bus not quite stopping in time | 0:05:48 | 0:05:51 | |
and gently nudging the Fiesta. | 0:05:51 | 0:05:53 | |
However, it's when you switch to the cameras inside the bus | 0:05:55 | 0:05:58 | |
that things start to look suspicious. | 0:05:58 | 0:06:02 | |
So, looking at the CCTV footage, | 0:06:02 | 0:06:03 | |
you can clearly see that this accident is very minor. | 0:06:03 | 0:06:07 | |
You can see that there's hardly any movement to any of the passengers. | 0:06:07 | 0:06:10 | |
Certainly, none of the passengers were thrown down the bus. | 0:06:10 | 0:06:14 | |
Bizarrely, you can see individuals patting each other on the backs. | 0:06:14 | 0:06:17 | |
You can see them laughing. | 0:06:17 | 0:06:19 | |
This certainly doesn't look like a bus full | 0:06:19 | 0:06:21 | |
of 60 seriously injured people. | 0:06:21 | 0:06:23 | |
It was clear the collision was extremely minor, | 0:06:25 | 0:06:28 | |
and there was no way the bus passengers could have sustained | 0:06:28 | 0:06:31 | |
the injuries they were claiming for. | 0:06:31 | 0:06:33 | |
All 60 claims were repudiated. | 0:06:33 | 0:06:36 | |
The case was closed and investigators thought | 0:06:36 | 0:06:38 | |
it was all over. | 0:06:38 | 0:06:40 | |
But some of the football supporters were in the mood | 0:06:43 | 0:06:46 | |
for some extra time, | 0:06:46 | 0:06:48 | |
and were determined to pursue their claims with the bus company. | 0:06:48 | 0:06:51 | |
Four of the claimants decided they wanted their day in court, | 0:06:52 | 0:06:55 | |
so they issued county court proceedings, | 0:06:55 | 0:06:57 | |
which we were more than happy with. | 0:06:57 | 0:06:59 | |
We've dealt with numerous claims like this and we were confident | 0:06:59 | 0:07:02 | |
of a successful outcome. | 0:07:02 | 0:07:03 | |
So, we instructed our fraud experts and also one of our top barristers | 0:07:03 | 0:07:07 | |
to represent us in court. | 0:07:07 | 0:07:09 | |
First Group turned to Horwich Farrelly, | 0:07:10 | 0:07:12 | |
a legal firm specialising in insurance claims, | 0:07:12 | 0:07:15 | |
to help defend the case. | 0:07:15 | 0:07:17 | |
And it was soon clear to them that the football supporters | 0:07:19 | 0:07:22 | |
didn't have a leg to stand on. | 0:07:22 | 0:07:24 | |
All four of the claimants who proceeded to trial | 0:07:25 | 0:07:28 | |
performed poorly in the witness box. | 0:07:28 | 0:07:30 | |
The inconsistencies in their evidence were fairly easily | 0:07:30 | 0:07:34 | |
exposed by cross-examination. | 0:07:34 | 0:07:37 | |
During the CCTV recording, | 0:07:41 | 0:07:43 | |
one of the claimants can be seen clutching his neck | 0:07:43 | 0:07:45 | |
as the bus hits the car. Yet, when presenting his claim, | 0:07:45 | 0:07:49 | |
it seems he forgot to get his facts straight. | 0:07:49 | 0:07:52 | |
This particular claimant's case was that he didn't feel any pain | 0:07:53 | 0:07:57 | |
or symptoms until the following day. | 0:07:57 | 0:07:59 | |
On that basis, unsurprisingly, | 0:07:59 | 0:08:02 | |
he was asked why he was clutching his neck | 0:08:02 | 0:08:05 | |
immediately after the accident, | 0:08:05 | 0:08:07 | |
and his response to the judge was to check if he was OK. | 0:08:07 | 0:08:11 | |
The judge just found that to be bizarre and implausible. | 0:08:11 | 0:08:14 | |
When viewing the CCTV after the collision, | 0:08:16 | 0:08:19 | |
it also looked like some of the supporters already had thoughts | 0:08:19 | 0:08:22 | |
of compensation in the forefront of their minds. | 0:08:22 | 0:08:25 | |
The footage shows all of the passengers disembarking the bus. | 0:08:27 | 0:08:31 | |
And whilst doing so, it can be seen | 0:08:31 | 0:08:34 | |
that five or six are taking pictures on their cellphones | 0:08:34 | 0:08:39 | |
of the bus driver, the front of the bus and the rear of the Ford Fiesta. | 0:08:39 | 0:08:43 | |
The fact that so many people were taking photographs | 0:08:45 | 0:08:49 | |
certainly gives the viewer the notion | 0:08:49 | 0:08:53 | |
that many of these passengers were immediately alive | 0:08:53 | 0:08:56 | |
to the prospect of compensation claims. | 0:08:56 | 0:08:58 | |
The judge had no hesitation in showing the claimants the red card. | 0:09:00 | 0:09:05 | |
All four claims were dismissed. | 0:09:05 | 0:09:07 | |
Two of the claimants were found to be fundamentally dishonest. | 0:09:07 | 0:09:11 | |
They were ordered to pay legal costs of just over £7,000 | 0:09:11 | 0:09:15 | |
and just under £5,000 respectively. | 0:09:15 | 0:09:19 | |
It was a superb result for Horwich Farrelly and First Group, | 0:09:19 | 0:09:23 | |
and a harsh lesson for the football fans who thought they could | 0:09:23 | 0:09:26 | |
cheat their way to an easy win. | 0:09:26 | 0:09:28 | |
I think it's probably fair to assume that most or all of these | 0:09:29 | 0:09:33 | |
60 claimants thought that this would be a fairly easy ride | 0:09:33 | 0:09:37 | |
and that they would get some compensation reasonably quickly. | 0:09:37 | 0:09:41 | |
I don't think any of them realised the efforts that First Group | 0:09:41 | 0:09:46 | |
and ourselves would go to in defending these claims. | 0:09:46 | 0:09:49 | |
And for anyone else who thinks bus companies are an easy touch | 0:09:53 | 0:09:56 | |
when it comes to compensation, Julie has a few words of advice. | 0:09:56 | 0:10:00 | |
For anyone thinking of pursuing a fraudulent claim | 0:10:01 | 0:10:04 | |
against our company, don't do it. If we catch you - and we will - | 0:10:04 | 0:10:07 | |
we will push for the toughest penalties, | 0:10:07 | 0:10:09 | |
and this could have serious financial implications | 0:10:09 | 0:10:12 | |
or even custodial sentences. | 0:10:12 | 0:10:14 | |
In America, it's the end of the road for the doctor | 0:10:21 | 0:10:24 | |
behind one of the largest fake prescription scams in US history. | 0:10:24 | 0:10:27 | |
Nowadays, social media has become a huge part of our lives. | 0:10:34 | 0:10:38 | |
In fact, around 32 million of us - | 0:10:38 | 0:10:40 | |
that's half the population of the UK - | 0:10:40 | 0:10:43 | |
have an online account. | 0:10:43 | 0:10:44 | |
Some are more secure than others, | 0:10:44 | 0:10:46 | |
but many allow your basic details to be seen by anyone. | 0:10:46 | 0:10:50 | |
Which is all well and good, so long as you don't have anything to hide. | 0:10:50 | 0:10:54 | |
Social media is being used more and more | 0:10:57 | 0:11:00 | |
when it comes to verifying claims. | 0:11:00 | 0:11:02 | |
Often people are caught out when posts on their online account | 0:11:04 | 0:11:07 | |
don't back up what they have told the insurers. | 0:11:07 | 0:11:10 | |
i-Cog are a claims management company that deal with cases | 0:11:13 | 0:11:16 | |
on behalf of insurers, | 0:11:16 | 0:11:18 | |
and recently dealt with a case regarding | 0:11:18 | 0:11:20 | |
a missing piece of jewellery. | 0:11:20 | 0:11:23 | |
The claim that we received from the insurers was for a ring | 0:11:26 | 0:11:30 | |
that had been lost while the policyholder was swimming | 0:11:30 | 0:11:33 | |
at the beach with a friend. | 0:11:33 | 0:11:35 | |
The claim was potentially worth £1,362. | 0:11:35 | 0:11:39 | |
The first thing they did was to call the claimant | 0:11:40 | 0:11:43 | |
to go through the facts. | 0:11:43 | 0:11:45 | |
So, this wasn't your average ring. | 0:12:27 | 0:12:29 | |
Designed by her partner, and with a truly distinctive look, | 0:12:29 | 0:12:33 | |
it's no wonder the claimant was upset after she had lost it. | 0:12:33 | 0:12:36 | |
Fair enough. Many people wait years for a proposal, | 0:12:59 | 0:13:03 | |
so to then lose your engagement ring | 0:13:03 | 0:13:05 | |
might make you feel lost without it. | 0:13:05 | 0:13:07 | |
So, picking up any old replacement sounded plausible enough... | 0:13:07 | 0:13:10 | |
..but there was a problem. | 0:13:10 | 0:13:12 | |
We do get claims like this quite often for rings that are lost. | 0:13:14 | 0:13:19 | |
However, the insurer had raised some concerns about this claim. | 0:13:19 | 0:13:23 | |
The insurer, as standard, did some background checking, | 0:13:24 | 0:13:27 | |
including some social media checks. | 0:13:27 | 0:13:29 | |
They found a post of an engagement ring | 0:13:29 | 0:13:32 | |
on the insured's Instagram account. | 0:13:32 | 0:13:36 | |
Nothing surprising there. | 0:13:37 | 0:13:38 | |
After all, what bride-to-be wouldn't want to show off their new | 0:13:38 | 0:13:41 | |
bling to friends and family? | 0:13:41 | 0:13:45 | |
The post was posted after the date of loss. | 0:13:45 | 0:13:49 | |
Ah. Surely there was a rational explanation? | 0:13:49 | 0:13:52 | |
We find it incredibly unusual that a ring could appear | 0:13:52 | 0:13:57 | |
on a social media site after the date that it was lost. | 0:13:57 | 0:14:00 | |
In which case, time to confront the claimant. | 0:14:01 | 0:14:05 | |
She immediately told us that | 0:14:54 | 0:14:56 | |
she didn't use Instagram very often. | 0:14:56 | 0:14:59 | |
She was unsure of what I was referring to. | 0:14:59 | 0:15:02 | |
And it wasn't until we went through the post that she put on there, | 0:15:02 | 0:15:05 | |
word for word, that she then came up with an account | 0:15:05 | 0:15:08 | |
of why she put that there. | 0:15:08 | 0:15:10 | |
So, the woman was claiming that the picture she had posted | 0:15:27 | 0:15:31 | |
of the beautiful and unique ring was, in fact, | 0:15:31 | 0:15:34 | |
the cheap and cheerful replacement she'd picked up on the high street. | 0:15:34 | 0:15:37 | |
Unsurprisingly, for both i-Cog and the woman's insurers, | 0:15:51 | 0:15:54 | |
it just didn't make sense. | 0:15:54 | 0:15:57 | |
Never mind pathetic. | 0:16:29 | 0:16:31 | |
I'd say it sounds rather suspicious. | 0:16:31 | 0:16:33 | |
This did not seem like a plausible account at all. | 0:16:34 | 0:16:37 | |
Very strange that you would put a photo of a ring up | 0:16:38 | 0:16:42 | |
and tell people that it is an engagement ring if it wasn't. | 0:16:42 | 0:16:45 | |
As if the explanation wasn't dubious enough, | 0:16:47 | 0:16:50 | |
as cheap and cheerful replacement rings go, | 0:16:50 | 0:16:53 | |
this one really looked the part. | 0:16:53 | 0:16:55 | |
Little did the claimant realise | 0:17:10 | 0:17:13 | |
i-Cog had done their homework. | 0:17:13 | 0:17:15 | |
Not only did they know where her original engagement ring | 0:17:15 | 0:17:17 | |
had come from, but crucially they also knew | 0:17:17 | 0:17:20 | |
exactly what it looked like. | 0:17:20 | 0:17:22 | |
Her husband-to-be must have been kicking himself | 0:17:53 | 0:17:56 | |
when he discovered she had found a ring | 0:17:56 | 0:17:58 | |
in a high-street costume jewellery shop that was identical | 0:17:58 | 0:18:02 | |
to the one he had designed and paid a small fortune for. | 0:18:02 | 0:18:06 | |
In my experience with jewellery claims, | 0:18:07 | 0:18:09 | |
it is unlikely that she would have been able to find | 0:18:09 | 0:18:11 | |
a piece of costume jewellery from a store just on the high street | 0:18:11 | 0:18:15 | |
that would have been similar enough in design | 0:18:15 | 0:18:19 | |
for the one that she says is her engagement ring. | 0:18:19 | 0:18:21 | |
But the woman was adamant the ring on her social media account | 0:18:23 | 0:18:26 | |
really was the cheap replacement she'd rushed out and bought. | 0:18:26 | 0:18:29 | |
So, all she needed was the receipt, | 0:18:38 | 0:18:40 | |
or a letter from the shop where she'd bought the cheap replacement, | 0:18:40 | 0:18:43 | |
and her claim would be settled. | 0:18:43 | 0:18:46 | |
So, a couple of days later the insured sent us an e-mail. | 0:18:46 | 0:18:49 | |
In that, she confirmed that she couldn't find a receipt | 0:18:49 | 0:18:52 | |
or purchase order for the substitute ring, | 0:18:52 | 0:18:56 | |
and as such she would like to withdraw the claim. | 0:18:56 | 0:19:00 | |
The fact that the woman had given up so quickly | 0:19:00 | 0:19:03 | |
on a claim worth over £1,300 spoke volumes. | 0:19:03 | 0:19:07 | |
So, the claim could have been easily validated. | 0:19:08 | 0:19:11 | |
We asked for proof of purchase for the ring. | 0:19:11 | 0:19:14 | |
She was unable to provide this, | 0:19:14 | 0:19:16 | |
which seems unusual because she had bought it from | 0:19:16 | 0:19:19 | |
a big name on the high street, | 0:19:19 | 0:19:21 | |
and they are usually, in my experience, very helpful, | 0:19:21 | 0:19:24 | |
especially when it is only a couple of weeks before. | 0:19:24 | 0:19:27 | |
It also seems very unusual that she would walk away from a claim | 0:19:27 | 0:19:31 | |
for such a sentimental and valuable item. | 0:19:31 | 0:19:34 | |
It appeared she thought her insurance company | 0:19:35 | 0:19:38 | |
wouldn't check up on her. | 0:19:38 | 0:19:39 | |
But like many would-be fraudsters before her, | 0:19:39 | 0:19:42 | |
the post on her online account had been her undoing. | 0:19:42 | 0:19:45 | |
We would always do checking on social media. | 0:19:47 | 0:19:50 | |
We have various sites that we check. | 0:19:51 | 0:19:54 | |
People tend to live their lives through social media now, | 0:19:54 | 0:19:57 | |
so it really is a good insight for the insurers to do those checks, | 0:19:57 | 0:20:01 | |
because unfortunately some people will live their life | 0:20:01 | 0:20:04 | |
through their posts, and sometimes this can catch them out. | 0:20:04 | 0:20:08 | |
Being involved in a car accident is never a pleasant experience, | 0:20:13 | 0:20:17 | |
but if you've been involved in an accident that wasn't your fault, | 0:20:17 | 0:20:20 | |
then sometimes you need to be able to prove it. | 0:20:20 | 0:20:23 | |
CCTV or dashcam footage can provide irrefutable evidence, | 0:20:23 | 0:20:27 | |
but unfortunately they are a luxury not many of us have access to. | 0:20:27 | 0:20:32 | |
Instead, we are reliant on eyewitness evidence | 0:20:32 | 0:20:34 | |
to help determine exactly what happened | 0:20:34 | 0:20:37 | |
and where the blame should lie. | 0:20:37 | 0:20:39 | |
When insurance companies receive claims, | 0:20:41 | 0:20:44 | |
the details are always validated before any money is paid. | 0:20:44 | 0:20:48 | |
This usually involves taking statements from the drivers | 0:20:48 | 0:20:50 | |
and any witnesses, | 0:20:50 | 0:20:52 | |
looking at the damage to the cars and, where necessary, | 0:20:52 | 0:20:55 | |
examining medical reports relating to any injuries. | 0:20:55 | 0:20:59 | |
AXA's Tom Wilson knows all too well | 0:21:03 | 0:21:05 | |
that some cases are easier to validate than others, | 0:21:05 | 0:21:08 | |
and that a single piece of evidence can be the crucial difference | 0:21:08 | 0:21:11 | |
between establishing whether a claim is genuine or fraudulent. | 0:21:11 | 0:21:15 | |
So, a customer reported to us that he'd been involved in a collision | 0:21:17 | 0:21:20 | |
with a Mr Khan. Mr Khan was rounding a bend | 0:21:20 | 0:21:23 | |
and our customer went into the rear of him... | 0:21:23 | 0:21:25 | |
..causing damage to both vehicles. | 0:21:27 | 0:21:29 | |
The value of our customer's vehicle damage was about £4,500. | 0:21:32 | 0:21:36 | |
And the value of Mr Khan's vehicle damage, | 0:21:36 | 0:21:38 | |
as a result of this vehicle becoming a total loss, | 0:21:38 | 0:21:40 | |
was £8,500. | 0:21:40 | 0:21:43 | |
With a total value of £13,000, | 0:21:43 | 0:21:46 | |
this was significantly more than a gentle rear-end shunt, | 0:21:46 | 0:21:50 | |
so the claim was thoroughly investigated. | 0:21:50 | 0:21:52 | |
Initially, the circumstances would appear genuine. | 0:21:54 | 0:21:57 | |
However, from the outset our customer made it clear | 0:21:57 | 0:22:00 | |
that he believed that the BMW had slammed his brakes on | 0:22:00 | 0:22:02 | |
for no apparent reason, which caused our customer to go into | 0:22:02 | 0:22:05 | |
the rear of the vehicle. | 0:22:05 | 0:22:07 | |
He believed he was the victim of a crash for cash | 0:22:07 | 0:22:10 | |
and that Mr Khan had induced this accident. | 0:22:10 | 0:22:13 | |
Crash for cash is when someone deliberately causes a collision | 0:22:13 | 0:22:16 | |
so they can cash in on the other party's insurance policy. | 0:22:16 | 0:22:20 | |
This is a practice often favoured by serial fraudsters or criminal gangs, | 0:22:20 | 0:22:25 | |
who induce accidents with innocent road users in order to profit | 0:22:25 | 0:22:29 | |
from fraudulent insurance claims. | 0:22:29 | 0:22:31 | |
With just one claim potentially worth thousands of pounds, | 0:22:31 | 0:22:35 | |
crash for cash is a big problem that costs the insurance industry | 0:22:35 | 0:22:38 | |
around £340 million a year. | 0:22:38 | 0:22:42 | |
In this case, AXA's policyholder needed proof that he really had | 0:22:45 | 0:22:48 | |
been the victim of a crash for cash scam, | 0:22:48 | 0:22:51 | |
and as luck would have it, he had exactly that. | 0:22:51 | 0:22:55 | |
The real key piece of information was a passer-by that witnessed | 0:22:55 | 0:22:58 | |
the accident actually stopped at the scene and informed us that | 0:22:58 | 0:23:02 | |
he'd been involved in a very similar accident at the same location | 0:23:02 | 0:23:06 | |
with the same third party only three months before. | 0:23:06 | 0:23:08 | |
That clearly gives us cause for concern. | 0:23:11 | 0:23:13 | |
They say lightning never strikes twice in the same place, | 0:23:14 | 0:23:18 | |
but the eyewitness was alleging that, just a matter of weeks before, | 0:23:18 | 0:23:22 | |
a near-identical crash had happened in the same way | 0:23:22 | 0:23:25 | |
on exactly the same stretch of road. | 0:23:25 | 0:23:28 | |
Coupled with the fact that our customer alleged that this guy | 0:23:28 | 0:23:31 | |
had slammed his brakes on for no reason, | 0:23:31 | 0:23:33 | |
it just builds a bigger picture about the credibility of this person | 0:23:33 | 0:23:36 | |
and actually the validity of the accident circumstances itself. | 0:23:36 | 0:23:41 | |
The police had attended the scene of the accident and also noticed | 0:23:41 | 0:23:44 | |
something rather suspicious. | 0:23:44 | 0:23:46 | |
The third-party vehicle, the BMW, was recovered by a recovery truck, | 0:23:46 | 0:23:50 | |
but when the recovery truck turned up, it was full of people already. | 0:23:50 | 0:23:53 | |
So, the driver of the BMW caught a lift with a vehicle that was waiting | 0:23:53 | 0:23:57 | |
a little way down the road. And it was suspected that that vehicle | 0:23:57 | 0:24:00 | |
had been waiting there all along. | 0:24:00 | 0:24:02 | |
It would suggest that the incident was planned, | 0:24:03 | 0:24:05 | |
that it was premeditated, | 0:24:05 | 0:24:07 | |
and that he was waiting there because he knew the accident | 0:24:07 | 0:24:09 | |
was going to take place at this location. | 0:24:09 | 0:24:12 | |
With the policyholder's suspicions, | 0:24:15 | 0:24:17 | |
the witness statement and information from the police | 0:24:17 | 0:24:19 | |
all pointing towards a fraudulent claim, | 0:24:19 | 0:24:22 | |
the insurance company was in no doubt of what to do next. | 0:24:22 | 0:24:26 | |
We informed the insurer of Mr Khan that we believed it to be | 0:24:26 | 0:24:30 | |
a deliberate action and believed it to be an induced accident, | 0:24:30 | 0:24:33 | |
and we weren't going to be paying his claim, | 0:24:33 | 0:24:35 | |
so we rejected his claim on that basis. | 0:24:35 | 0:24:37 | |
Legal action was taken against Mr Khan, | 0:24:40 | 0:24:42 | |
and the case proceeded to court. | 0:24:42 | 0:24:45 | |
So, Mr Khan was required to attend a hearing, | 0:24:45 | 0:24:47 | |
where he was found guilty of conspiracy to defraud | 0:24:47 | 0:24:50 | |
and fraud by misrepresentation, | 0:24:50 | 0:24:52 | |
and he was sentenced to 20 months behind bars. | 0:24:52 | 0:24:55 | |
The sentence handed down in this particular case | 0:25:00 | 0:25:02 | |
was a strong sentence, and to receive a custodial sentence, | 0:25:02 | 0:25:05 | |
primarily, for Mr Khan, is a great result. | 0:25:05 | 0:25:08 | |
It sends the message of a deterrent to would-be fraudsters | 0:25:08 | 0:25:12 | |
that if you do try and you get caught, and we will catch you, | 0:25:12 | 0:25:15 | |
that you could end up with a prison sentence. | 0:25:15 | 0:25:18 | |
With another fraudster caught and punished for his actions, | 0:25:20 | 0:25:23 | |
it was a great result for AXA, | 0:25:23 | 0:25:25 | |
and showed just how important it is in cases like these | 0:25:25 | 0:25:28 | |
for witnesses to come forward. | 0:25:28 | 0:25:30 | |
In respect of our investigation, the witness being there | 0:25:32 | 0:25:34 | |
was absolutely key to being able to prove that this was a fraud. | 0:25:34 | 0:25:38 | |
Had he not been present, | 0:25:38 | 0:25:39 | |
it would effectively be our customer's word against the word | 0:25:39 | 0:25:42 | |
of the third party, so it would make it very difficult for us | 0:25:42 | 0:25:46 | |
to prove that it was an induced accident. | 0:25:46 | 0:25:48 | |
Still to come: | 0:25:53 | 0:25:55 | |
a motorist's attempt to exaggerate his claim backfires | 0:25:55 | 0:25:58 | |
when he makes a basic mistake. | 0:25:58 | 0:26:01 | |
He categorically denied that he'd suffered any injury when asked. | 0:26:01 | 0:26:05 | |
As we've seen in many cases on this programme, | 0:26:15 | 0:26:18 | |
fraudsters will go to extreme lengths to get their hands | 0:26:18 | 0:26:21 | |
on a pay-out, from deliberately causing an accident | 0:26:21 | 0:26:24 | |
to claiming for medical treatment they never even received. | 0:26:24 | 0:26:27 | |
But if you think we've got it bad in the UK, | 0:26:27 | 0:26:30 | |
the depths some fraudsters go to across the pond | 0:26:30 | 0:26:33 | |
is simply astonishing. | 0:26:33 | 0:26:35 | |
In America, the largest type of insurance fraud by far | 0:26:37 | 0:26:41 | |
is scams against health care insurers. | 0:26:41 | 0:26:43 | |
The exact size of the problem is unknown, | 0:26:45 | 0:26:47 | |
but it is likely to be tens of billions of dollars a year. | 0:26:47 | 0:26:51 | |
Out of all the people we trust, | 0:26:53 | 0:26:55 | |
doctors are usually high on the list. | 0:26:55 | 0:26:57 | |
But sadly, as many of these cases have proved, | 0:26:57 | 0:27:00 | |
not all medical experts are running practices | 0:27:00 | 0:27:03 | |
that are entirely above board. | 0:27:03 | 0:27:05 | |
In Miami, Florida, Fernando Mendez-Villamil | 0:27:18 | 0:27:21 | |
qualified as a doctor in 1998 | 0:27:21 | 0:27:23 | |
and set up his own psychiatric practice, | 0:27:23 | 0:27:26 | |
treating patients for conditions such as ADHD, schizophrenia, | 0:27:26 | 0:27:30 | |
depression and narcolepsy. | 0:27:30 | 0:27:33 | |
But just four years later, | 0:27:35 | 0:27:37 | |
he began defrauding the government health care providers in a scam | 0:27:37 | 0:27:40 | |
that would last for the next 14 years | 0:27:40 | 0:27:43 | |
and cost the US government millions of dollars. | 0:27:43 | 0:27:47 | |
His plan involved staffing his office with low-paid workers | 0:27:49 | 0:27:53 | |
who would carry out the tasks he gave them without question. | 0:27:53 | 0:27:56 | |
His scheme was simple. | 0:27:59 | 0:28:01 | |
People who wanted to get disability benefits | 0:28:01 | 0:28:03 | |
but who didn't actually have a mental health problem | 0:28:03 | 0:28:06 | |
would pay him around 1,500. | 0:28:06 | 0:28:09 | |
In exchange, he would give them a false diagnosis, | 0:28:09 | 0:28:12 | |
along with fake medical records and prescriptions, | 0:28:12 | 0:28:15 | |
so they could apply for the benefits. | 0:28:15 | 0:28:18 | |
These people would then attend a disability determination interview, | 0:28:21 | 0:28:25 | |
where they would be questioned about their alleged mental illness. | 0:28:25 | 0:28:28 | |
Mendez-Villamil would prepare them for these interviews, | 0:28:29 | 0:28:33 | |
telling them how to respond, | 0:28:33 | 0:28:34 | |
so it looked like they were genuinely suffering | 0:28:34 | 0:28:37 | |
from severe mental health issues. | 0:28:37 | 0:28:39 | |
He would then submit false claims to the government | 0:28:41 | 0:28:43 | |
health insurance programmes, Medicare and Medicaid, | 0:28:43 | 0:28:46 | |
for appointments that never took place, | 0:28:46 | 0:28:48 | |
and prescriptions that weren't actually necessary. | 0:28:48 | 0:28:51 | |
While all this was going on, | 0:28:56 | 0:28:58 | |
he continued to treat legitimate patients at his practice. | 0:28:58 | 0:29:01 | |
But he even preyed on these innocent victims too, | 0:29:01 | 0:29:04 | |
by giving over-the-top diagnoses | 0:29:04 | 0:29:07 | |
and prescribing excessive amounts of medication. | 0:29:07 | 0:29:10 | |
By 2004, he had earned the title of the most prolific | 0:29:12 | 0:29:15 | |
drug provider in Florida, | 0:29:15 | 0:29:17 | |
issuing some 62,000 prescriptions a year, | 0:29:17 | 0:29:21 | |
costing 12.2 million. | 0:29:21 | 0:29:25 | |
That's over 1,000 prescriptions a week. | 0:29:25 | 0:29:27 | |
But his epic attempt at fraud didn't go unnoticed. | 0:29:29 | 0:29:33 | |
Three years later, Medicaid received a complaint | 0:29:33 | 0:29:36 | |
from a private investigator called Ken Kramer. | 0:29:36 | 0:29:39 | |
Kramer had noticed that Mendez-Villamil | 0:29:40 | 0:29:42 | |
was prescribing a huge and totally disproportionate amount | 0:29:42 | 0:29:45 | |
of anti-psychotic drugs to children. | 0:29:45 | 0:29:48 | |
The information was passed on to the US Senate, | 0:29:50 | 0:29:53 | |
who made the prescription records available to the public. | 0:29:53 | 0:29:56 | |
By that time, he had an astounding 96,000 mental health patients | 0:29:56 | 0:30:02 | |
on his books. | 0:30:02 | 0:30:04 | |
When questioned, Mendez-Villamil | 0:30:05 | 0:30:06 | |
insisted that the number of prescriptions he was issuing | 0:30:06 | 0:30:09 | |
was normal for this volume of patients. | 0:30:09 | 0:30:12 | |
But the authorities thought otherwise. | 0:30:12 | 0:30:14 | |
Medicaid terminated him as a health care provider, | 0:30:19 | 0:30:22 | |
meaning he could no longer claim any money from them. | 0:30:22 | 0:30:26 | |
But that didn't stop this fraudster. | 0:30:26 | 0:30:28 | |
He continued to submit claims to Medicare, | 0:30:28 | 0:30:31 | |
who cover those aged over 65 | 0:30:31 | 0:30:34 | |
and young people with disabilities. | 0:30:34 | 0:30:36 | |
Some of his patients were as young as three, | 0:30:37 | 0:30:39 | |
and were being prescribed huge amounts of medication | 0:30:39 | 0:30:42 | |
for no apparent reason. | 0:30:42 | 0:30:44 | |
The notes on their medical reports also frequently | 0:30:46 | 0:30:49 | |
contradicted each other, a clear sign that something wasn't right. | 0:30:49 | 0:30:53 | |
Not only was Mendez-Villamil | 0:30:54 | 0:30:56 | |
helping thousands of people to fraudulently | 0:30:56 | 0:30:58 | |
receive disability benefit, | 0:30:58 | 0:31:00 | |
but he was also claiming money from health care providers | 0:31:00 | 0:31:03 | |
that he wasn't owed. And on top of that, | 0:31:03 | 0:31:06 | |
he was flooding the streets of Florida with drugs | 0:31:06 | 0:31:08 | |
that should never have been prescribed. | 0:31:08 | 0:31:11 | |
He needed to be stopped. | 0:31:11 | 0:31:13 | |
In 2013, Mendez-Villamil | 0:31:14 | 0:31:16 | |
was struck off Medicare's list of providers. | 0:31:16 | 0:31:19 | |
He received a 15,000 fine from the Florida Board of Medicine | 0:31:19 | 0:31:23 | |
and was asked to reimburse the state more than 22,000 in costs. | 0:31:23 | 0:31:28 | |
Unfazed by this attempt to put a stop to his illegal scam, | 0:31:31 | 0:31:34 | |
he came up with yet another plan. | 0:31:34 | 0:31:37 | |
This time, he targeted immigrants who wanted to become US citizens. | 0:31:38 | 0:31:43 | |
In exchange for a 1,000 cash fee, | 0:31:43 | 0:31:46 | |
he would diagnose them with a false mental illness so they wouldn't have | 0:31:46 | 0:31:49 | |
to adhere to all of the country's strict immigration rules. | 0:31:49 | 0:31:53 | |
But he had gone too far, and the law had caught up with him. | 0:31:54 | 0:31:58 | |
In January 2016, | 0:32:02 | 0:32:03 | |
he was accused of running one of the largest fake prescription schemes | 0:32:03 | 0:32:07 | |
in US history, and was immediately arrested. | 0:32:07 | 0:32:10 | |
His home and valuable possessions were seized, | 0:32:13 | 0:32:15 | |
including a rather unusual collection of paintings | 0:32:15 | 0:32:18 | |
estimated to be worth around 500,000. | 0:32:18 | 0:32:22 | |
He later pleaded guilty to conspiracy to commit | 0:32:22 | 0:32:25 | |
health care fraud, to make false statements in immigration matters | 0:32:25 | 0:32:28 | |
and to defrauding the US government. | 0:32:28 | 0:32:30 | |
Overall, his scam had cost the Citizenship and Immigration Services | 0:32:34 | 0:32:38 | |
over 800,000, | 0:32:38 | 0:32:40 | |
the United States disability system more than 20 million | 0:32:40 | 0:32:45 | |
and health care providers Medicare and Medicaid over 29 million. | 0:32:45 | 0:32:49 | |
Mendez-Villamil was sentenced to 12 years and seven months in prison, | 0:32:53 | 0:32:58 | |
and ordered to pay back costs of over 50 million. | 0:32:58 | 0:33:02 | |
Although justice had finally been served, | 0:33:12 | 0:33:15 | |
this was a man who had abused his position | 0:33:15 | 0:33:17 | |
to an unimaginable degree. | 0:33:17 | 0:33:20 | |
It will also take some time to identify the thousands of patients | 0:33:20 | 0:33:24 | |
he has given false diagnoses to, | 0:33:24 | 0:33:26 | |
who are still out there defrauding the US government. | 0:33:26 | 0:33:29 | |
Temptation. It can come in various forms, but for many of us | 0:33:38 | 0:33:42 | |
the promise of free money is something that is | 0:33:42 | 0:33:45 | |
very hard to turn down. Now, if you own a phone, | 0:33:45 | 0:33:48 | |
then the chances are that at some point you've received a call | 0:33:48 | 0:33:51 | |
telling you that there is a pot of cash with your name on it | 0:33:51 | 0:33:54 | |
waiting for you to collect as compensation | 0:33:54 | 0:33:57 | |
for the accident you were involved in... | 0:33:57 | 0:33:59 | |
..sometimes even if you haven't been in an accident. | 0:33:59 | 0:34:03 | |
Well, this next case highlights the potential pitfalls of pursuing | 0:34:03 | 0:34:06 | |
a claim that you simply aren't entitled to. | 0:34:06 | 0:34:09 | |
BLM are a legal firm who represent a number of insurance companies. | 0:34:12 | 0:34:16 | |
One of their partners, Naomi Grant, dealt with a case | 0:34:16 | 0:34:19 | |
from a particularly persistent claimant who was determined | 0:34:19 | 0:34:22 | |
to get what he thought he was owed. | 0:34:22 | 0:34:24 | |
The insurers in this case were initially just presented with | 0:34:26 | 0:34:29 | |
a straightforward claim for vehicle damage | 0:34:29 | 0:34:31 | |
arising out of a road traffic accident. | 0:34:31 | 0:34:34 | |
Both parties were travelling in opposite directions | 0:34:34 | 0:34:37 | |
along a fairly narrow country road, and in the process, | 0:34:37 | 0:34:40 | |
they came into collision with one another. | 0:34:40 | 0:34:44 | |
The initial incident wasn't suspicious in any way. | 0:34:44 | 0:34:47 | |
At first presentation, this was just a claim for vehicle damage. | 0:34:47 | 0:34:50 | |
So, an unfortunate coming together of two cars, | 0:34:50 | 0:34:53 | |
but thankfully no-one was injured, | 0:34:53 | 0:34:55 | |
and it was a straightforward claim to process. | 0:34:55 | 0:34:57 | |
As a routine part of dealing with the vehicle damage claim, | 0:34:57 | 0:35:01 | |
the claimant made a telephone call to the insurance company | 0:35:01 | 0:35:05 | |
about two months after the initial accident. | 0:35:05 | 0:35:07 | |
So, with the exception of the ill feeling between the two parties, | 0:35:49 | 0:35:52 | |
this was a simple matter of repairing the vehicles | 0:35:52 | 0:35:55 | |
and closing the case... | 0:35:55 | 0:35:57 | |
..or so the insurance company thought. | 0:35:59 | 0:36:02 | |
Eight months after the initial accident, | 0:36:02 | 0:36:05 | |
the insurance company received a claim notification form | 0:36:05 | 0:36:09 | |
from a firm of solicitors appointed on behalf of the claimant, | 0:36:09 | 0:36:13 | |
and at that point the claimant alleged | 0:36:13 | 0:36:15 | |
that he'd suffered personal injury. | 0:36:15 | 0:36:17 | |
Although eight months might sound like a long time, | 0:36:17 | 0:36:20 | |
with many genuine claims this is actually quite a regular occurrence. | 0:36:20 | 0:36:24 | |
It's not uncommon for people to present claims quite some time | 0:36:25 | 0:36:29 | |
after the accident. | 0:36:29 | 0:36:31 | |
The law in England and Wales is that a person has three years | 0:36:31 | 0:36:34 | |
from the date of an accident before they have to actually | 0:36:34 | 0:36:37 | |
issue court proceedings to bring their claim. | 0:36:37 | 0:36:40 | |
So, technically the claimant in this matter did nothing wrong. | 0:36:40 | 0:36:44 | |
"Technically" being the key word there, | 0:36:44 | 0:36:47 | |
because it was at this point that things began to unravel. | 0:36:47 | 0:36:50 | |
The claimant had indicated that he had suffered personal injury, | 0:36:51 | 0:36:55 | |
but he didn't present any other evidence to go with that, | 0:36:55 | 0:36:58 | |
so the claim then had to be reopened and looked at again, | 0:36:58 | 0:37:01 | |
which caused the insurance company to go back through their call log | 0:37:01 | 0:37:05 | |
to locate the call when he categorically denied | 0:37:05 | 0:37:08 | |
that he'd suffered any injury when asked. | 0:37:08 | 0:37:11 | |
That immediately aroused their suspicions. | 0:37:18 | 0:37:20 | |
The insurance company therefore disclosed a copy | 0:37:20 | 0:37:23 | |
of that call recording to the solicitors, | 0:37:23 | 0:37:25 | |
who appeared to go away and discontinue the claim, | 0:37:25 | 0:37:28 | |
so again the file was closed down. | 0:37:28 | 0:37:31 | |
It looked as though this chap had tried to submit a cheeky claim | 0:37:32 | 0:37:35 | |
in the hope of some easy money, | 0:37:35 | 0:37:37 | |
but his underhanded attempt had been scuppered by his own voice | 0:37:37 | 0:37:41 | |
on the original call recording, | 0:37:41 | 0:37:43 | |
where he'd said he was completely unscathed by the car accident. | 0:37:43 | 0:37:47 | |
With evidence as conclusive as that, | 0:37:49 | 0:37:51 | |
most people would leave it there. | 0:37:51 | 0:37:53 | |
But it soon transpired this fella wasn't most people. | 0:37:53 | 0:37:56 | |
The bigger surprise was that some 18 months after the accident, | 0:37:59 | 0:38:03 | |
he re-presented his claim through a second firm of solicitors, | 0:38:03 | 0:38:08 | |
again maintaining that he had been injured. | 0:38:08 | 0:38:12 | |
The call recording was again immediately disclosed, | 0:38:12 | 0:38:15 | |
but the claimant insisted that he'd suffered an injury, | 0:38:15 | 0:38:19 | |
and this time went on to get a medical examination | 0:38:19 | 0:38:23 | |
and a medical report to detail all of his alleged injuries. | 0:38:23 | 0:38:27 | |
Either this was someone who firmly believed in the phrase | 0:38:27 | 0:38:30 | |
"third time lucky" or he was being given some very poor advice. | 0:38:30 | 0:38:34 | |
But at least this time he had some documents to back up his claim. | 0:38:36 | 0:38:40 | |
The medical report stated that he'd suffered a neck injury, | 0:38:40 | 0:38:44 | |
which he said he had suffered from for five months. | 0:38:44 | 0:38:47 | |
He also claimed that he had been affected in his domestic duties, | 0:38:47 | 0:38:52 | |
so he was unable to clean, cook or shop. | 0:38:52 | 0:38:56 | |
He couldn't carry out any leisure activities, | 0:38:56 | 0:38:58 | |
he was unable to play football, | 0:38:58 | 0:39:00 | |
and he claimed he was unable to sleep properly. | 0:39:00 | 0:39:03 | |
So, from no injuries at all to a list of ailments that added up | 0:39:03 | 0:39:07 | |
to a pretty hefty claim for compensation. | 0:39:07 | 0:39:10 | |
So, all in all, the claim was valued in the region of £8,000. | 0:39:10 | 0:39:15 | |
Now, given this man categorically said he was uninjured, | 0:39:15 | 0:39:18 | |
it will come as no surprise that the insurance company | 0:39:18 | 0:39:21 | |
had no intention of paying this claim. | 0:39:21 | 0:39:24 | |
So, they instructed BLM to defend it all the way, | 0:39:24 | 0:39:27 | |
which they duly did. | 0:39:27 | 0:39:30 | |
We were able to prepare a robust defence, | 0:39:31 | 0:39:34 | |
referring to the phone call, | 0:39:34 | 0:39:35 | |
which really set out all the facts. | 0:39:35 | 0:39:38 | |
And that defence quite categorically stated that this was | 0:39:38 | 0:39:41 | |
a fraudulent claim in the eyes of the insurance company. | 0:39:41 | 0:39:45 | |
Sounds like a pretty one-sided fight, | 0:39:45 | 0:39:47 | |
but with the prospect of a pay-out on the line, | 0:39:47 | 0:39:50 | |
this guy wasn't one to give in easily. | 0:39:50 | 0:39:52 | |
The claimant in this matter actually continued with his claim | 0:39:53 | 0:39:56 | |
for quite a long time, | 0:39:56 | 0:39:58 | |
despite having been presented with all the evidence, | 0:39:58 | 0:40:01 | |
which was quite irrefutable, early on. | 0:40:01 | 0:40:04 | |
In a further twist to the tale, | 0:40:04 | 0:40:06 | |
two months before the matter was due to be listed for trial, | 0:40:06 | 0:40:09 | |
the claimant then made the sensible decision to discontinue his claim. | 0:40:09 | 0:40:13 | |
But if he thought that was the end of the matter, | 0:40:15 | 0:40:17 | |
then he was in for a very nasty surprise indeed. | 0:40:17 | 0:40:20 | |
In common with many people, | 0:40:21 | 0:40:23 | |
the claimant in this instance really thought that | 0:40:23 | 0:40:25 | |
by discontinuing his claim he could just run away from everything | 0:40:25 | 0:40:29 | |
and drop his claim and that would be an end to the matter. | 0:40:29 | 0:40:33 | |
Unfortunately for him, that wasn't to be the case. | 0:40:34 | 0:40:37 | |
The insurance company in this matter had spent a considerable amount | 0:40:37 | 0:40:40 | |
of time, effort and resource in having to defend not only his claim | 0:40:40 | 0:40:44 | |
but to pursue the claim against him, | 0:40:44 | 0:40:47 | |
and in the judgment that was recognised by the judge, | 0:40:47 | 0:40:50 | |
who actually awarded the insurance company a sum | 0:40:50 | 0:40:54 | |
towards their own investigation costs. | 0:40:54 | 0:40:56 | |
The claimant was also ordered to pay a sum of money by way of damages, | 0:40:58 | 0:41:02 | |
to punish him for what he'd done in bringing the claims. | 0:41:02 | 0:41:06 | |
And he was ordered to pay a considerable amount | 0:41:06 | 0:41:08 | |
in respect of costs. | 0:41:08 | 0:41:10 | |
So, in total, for what he thought he could walk away from, | 0:41:10 | 0:41:14 | |
he ended up with a judgment of over £15,000. | 0:41:14 | 0:41:17 | |
The catalyst for many personal injury claims brought | 0:41:17 | 0:41:20 | |
a long time after accidents are phone calls from companies | 0:41:20 | 0:41:24 | |
telling people they're entitled to compensation. | 0:41:24 | 0:41:27 | |
At best, these calls are irritating, | 0:41:27 | 0:41:29 | |
but at worst, they can be a gateway to a whole host of problems. | 0:41:29 | 0:41:34 | |
I think there's quite a huge, | 0:41:34 | 0:41:36 | |
growing problem at the moment with cold calling | 0:41:36 | 0:41:40 | |
and people being approached and pressurised into bringing claims, | 0:41:40 | 0:41:44 | |
even where they haven't been injured. | 0:41:44 | 0:41:46 | |
They are assured that this money is there for the taking, it is there, | 0:41:46 | 0:41:49 | |
there is a cheque with their name on it, | 0:41:49 | 0:41:51 | |
all they have to do is fill in a couple of forms and it is theirs. | 0:41:51 | 0:41:56 | |
It's not that straightforward. | 0:41:56 | 0:41:57 | |
You do still have to prove your claim. | 0:41:57 | 0:41:59 | |
You've got to prove your injury. | 0:41:59 | 0:42:02 | |
As this case demonstrates, | 0:42:02 | 0:42:04 | |
it's important to remember that it's the claimant who will ultimately | 0:42:04 | 0:42:07 | |
be held accountable for dishonest or opportunistic claims, | 0:42:07 | 0:42:11 | |
which can result in huge cost orders and even prison sentences. | 0:42:11 | 0:42:15 | |
The advice to anybody who is receiving these phone calls | 0:42:17 | 0:42:20 | |
is really be honest, be truthful. | 0:42:20 | 0:42:23 | |
Not all of the companies that phone you offering sums of money, | 0:42:23 | 0:42:27 | |
offering compensation, have your best interests at heart. | 0:42:27 | 0:42:30 | |
So, at the end of the day, be honest when you're presenting a claim. | 0:42:30 | 0:42:33 | |
Whether it's exaggerating real injuries, | 0:42:39 | 0:42:41 | |
totally making up a story for a dodgy claim | 0:42:41 | 0:42:43 | |
or masterminding insurance fraud on an industrial scale, | 0:42:43 | 0:42:47 | |
the law is coming down hard on the people who think | 0:42:47 | 0:42:50 | |
they can make a quick buck with their insurance scams and cons. | 0:42:50 | 0:42:53 | |
But the fraudsters need to think again, | 0:42:53 | 0:42:56 | |
as more of them than ever before are being caught in the act, | 0:42:56 | 0:42:59 | |
and claimed and shamed. | 0:42:59 | 0:43:03 |