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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 | |
Subject out of the vehicle. | 0:00:41 | 0:00:44 | |
..sophisticated data analysis techniques... | 0:00:44 | 0:00:46 | |
..and a number of highly skilled police units... | 0:00:49 | 0:00:51 | |
Police! Don't move. Stay where you are! | 0:00:51 | 0:00:53 | |
..they're catching the criminals red-handed. | 0:00:53 | 0:00:55 | |
Just don't lie to us. | 0:00:55 | 0:00:58 | |
All those conmen, scammers and cheats on the fiddle | 0:00:58 | 0:01:01 | |
are now caught in the act and claimed and shamed. | 0:01:01 | 0:01:04 | |
..a chancer's ruse is rumbled when CCTV footage comes to light... | 0:01:12 | 0:01:16 | |
We were completely shocked that the claimant had the nerve to submit | 0:01:17 | 0:01:21 | |
a personal injury claim when it was quite clear that he wasn't even | 0:01:21 | 0:01:24 | |
in the car and he couldn't possibly have been injured. | 0:01:24 | 0:01:27 | |
..a woman's holiday hoax is exposed thanks to her | 0:01:27 | 0:01:30 | |
childish counterfeit skills... | 0:01:30 | 0:01:32 | |
My daughter could have completed them considerably better, | 0:01:34 | 0:01:36 | |
and she's eight years old. | 0:01:36 | 0:01:38 | |
..and it's bad news for a burglary claim | 0:01:38 | 0:01:41 | |
when insurers clock a fatal flaw. | 0:01:41 | 0:01:43 | |
Our agent recognised headlines in that newspaper, | 0:01:43 | 0:01:46 | |
and thought that they were more recent than the photograph | 0:01:46 | 0:01:50 | |
could potentially have been taken. | 0:01:50 | 0:01:52 | |
The most common and expensive type of insurance fraud | 0:01:56 | 0:01:59 | |
is bogus car claims. | 0:01:59 | 0:02:01 | |
Now, many of these claims start out as genuine cases, | 0:02:01 | 0:02:04 | |
but when unscrupulous claimants see an opportunity | 0:02:04 | 0:02:07 | |
to line their pockets, | 0:02:07 | 0:02:09 | |
the temptation to exaggerate or even make up | 0:02:09 | 0:02:12 | |
entirely fictitious circumstances can be too great. | 0:02:12 | 0:02:15 | |
Thinking they can get away with it, | 0:02:15 | 0:02:17 | |
they'll go to extreme lengths to prove their case is genuine, | 0:02:17 | 0:02:21 | |
refusing to give up even when faced with the hard evidence | 0:02:21 | 0:02:25 | |
that says otherwise. | 0:02:25 | 0:02:27 | |
Simon Roylance heads up the claims crime prevention team | 0:02:30 | 0:02:33 | |
at LV Insurance, and recently dealt with a case where one claimant | 0:02:33 | 0:02:37 | |
went above and beyond to prove their case was genuine. | 0:02:37 | 0:02:40 | |
Our customer contacted us to advise that she'd been in an accident | 0:02:42 | 0:02:45 | |
in a car park. | 0:02:45 | 0:02:47 | |
She said that as she was reversing from a parking bay, | 0:02:47 | 0:02:50 | |
she made contact with the front of another vehicle | 0:02:50 | 0:02:53 | |
that was parked in a bay opposite. | 0:02:53 | 0:02:55 | |
This vehicle was owned and allegedly driven by the claimant. | 0:02:55 | 0:02:59 | |
So, all in all, this was pretty much the most common type of car accident | 0:03:00 | 0:03:04 | |
that motor insurers see on a daily basis. | 0:03:04 | 0:03:08 | |
Whilst there was no damage to our customer's vehicle, | 0:03:08 | 0:03:10 | |
we did offer to deal with repairs to the third-party vehicle. | 0:03:10 | 0:03:14 | |
We got this in to a repairer, | 0:03:14 | 0:03:15 | |
and dealt with the claim in the sum of about £1,100. | 0:03:15 | 0:03:19 | |
But if LV thought they had settled the claim and the case was closed, | 0:03:20 | 0:03:23 | |
then they were wrong. | 0:03:23 | 0:03:25 | |
At around the same time, we received a letter | 0:03:25 | 0:03:27 | |
from a solicitor stating that the claimant | 0:03:27 | 0:03:30 | |
had sustained injuries in the accident | 0:03:30 | 0:03:33 | |
to his neck, back and arms. | 0:03:33 | 0:03:36 | |
These appear to be typical kind of whiplash injuries that we see | 0:03:36 | 0:03:39 | |
in road traffic accidents. | 0:03:39 | 0:03:41 | |
Once again, this was all standard stuff. | 0:03:42 | 0:03:45 | |
LV's policyholder had admitted she had reversed into another car, | 0:03:45 | 0:03:49 | |
and the impact must have injured the man behind the wheel of the car | 0:03:49 | 0:03:52 | |
she had hit. | 0:03:52 | 0:03:54 | |
As this guy was now claiming for injuries on top of the repairs | 0:03:54 | 0:03:57 | |
to his car, LV decided to give their policyholder | 0:03:57 | 0:04:00 | |
a quick call to see if her account | 0:04:00 | 0:04:03 | |
suggested the impact was sufficient to have injured him. | 0:04:03 | 0:04:06 | |
When we spoke to our customer, | 0:05:11 | 0:05:12 | |
she was really quite adamant that the claimant wasn't even in the car | 0:05:12 | 0:05:16 | |
at the time, and she did seem very certain about this. | 0:05:16 | 0:05:19 | |
As discrepancies in versions of events go, | 0:05:21 | 0:05:24 | |
this one was a whopper. | 0:05:24 | 0:05:26 | |
Fortunately, there was a sure-fire way of establishing | 0:05:26 | 0:05:29 | |
who was telling the truth and who was not. | 0:05:29 | 0:05:33 | |
The car park was covered by CCTV cameras, and as luck would have it, | 0:05:33 | 0:05:37 | |
they captured the entire sequence of events. | 0:05:37 | 0:05:41 | |
On the right of the picture, you've got the store. | 0:05:41 | 0:05:44 | |
Just in front of the store is the claimant's car, which is parked up. | 0:05:44 | 0:05:48 | |
In the parking bay opposite is our customer's vehicle, | 0:05:48 | 0:05:51 | |
and you see that she soon starts to reverse manoeuvre | 0:05:51 | 0:05:54 | |
out of her parking bay. | 0:05:54 | 0:05:56 | |
She keeps reversing, | 0:05:56 | 0:05:58 | |
and makes slight contact with the front of the claimant's vehicle. | 0:05:58 | 0:06:01 | |
But as you can see throughout this time, | 0:06:02 | 0:06:05 | |
the claimant has been stood alongside his car. | 0:06:05 | 0:06:07 | |
He's not been in the vehicle. | 0:06:07 | 0:06:09 | |
And you can actually see him trying to catch our customer's attention | 0:06:09 | 0:06:12 | |
after she's collided with his car. | 0:06:12 | 0:06:14 | |
The footage provided indisputable proof that LV's policyholder | 0:06:14 | 0:06:18 | |
was telling the truth, | 0:06:18 | 0:06:20 | |
and that the man was attempting to make a fraudulent claim. | 0:06:20 | 0:06:24 | |
When we first looked at the CCTV footage, | 0:06:24 | 0:06:28 | |
we were completely shocked that the claimant had the nerve to submit | 0:06:28 | 0:06:31 | |
a personal injury claim when it was quite clear that he wasn't even | 0:06:31 | 0:06:34 | |
in the car, and he couldn't possibly have been injured. | 0:06:34 | 0:06:37 | |
We advised the claimant's solicitors that we wouldn't be making | 0:06:38 | 0:06:41 | |
any payments, because we didn't accept that their client | 0:06:41 | 0:06:44 | |
was in the vehicle at the time of the accident. | 0:06:44 | 0:06:47 | |
With evidence like that, | 0:06:47 | 0:06:49 | |
LV would be forgiven for thinking it was case closed. | 0:06:49 | 0:06:53 | |
Well, think again. | 0:06:53 | 0:06:55 | |
We were then completely taken aback a few months later | 0:06:55 | 0:06:58 | |
to receive a medical report from the claimant's solicitor | 0:06:58 | 0:07:02 | |
stating that he had been to see his GP twice since the accident | 0:07:02 | 0:07:05 | |
regarding neck and back pain, | 0:07:05 | 0:07:08 | |
and furthermore it said that it had taken 18 months to recover | 0:07:08 | 0:07:12 | |
from his injuries. But we already knew that he wasn't in the car | 0:07:12 | 0:07:15 | |
in the first place. | 0:07:15 | 0:07:17 | |
Claiming it would take 18 months to recover from injuries | 0:07:17 | 0:07:20 | |
he'd never sustained, this guy had more front than Brighton. | 0:07:20 | 0:07:24 | |
But LV had heard enough. | 0:07:24 | 0:07:27 | |
We then contacted the claimant's solicitors and made it clear | 0:07:27 | 0:07:30 | |
to them that we didn't accept that their client was in the vehicle | 0:07:30 | 0:07:33 | |
at the time, and so we wouldn't be making any payments | 0:07:33 | 0:07:35 | |
for his compensation claim. | 0:07:35 | 0:07:37 | |
But they weren't prepared to leave it there, and referred the case | 0:07:39 | 0:07:42 | |
to the insurance fraud enforcement department | 0:07:42 | 0:07:44 | |
at the City of London Police. | 0:07:44 | 0:07:46 | |
IFED went out to interview the claimant. | 0:07:46 | 0:07:49 | |
Initially, he stuck to his story, but when they showed him the CCTV, | 0:07:49 | 0:07:52 | |
he eventually admitted that he'd made the whole thing up. | 0:07:52 | 0:07:57 | |
The consequences for the claimant where that we repudiated | 0:07:57 | 0:08:01 | |
his injury claim, worth up to around 5,000 in full. | 0:08:01 | 0:08:05 | |
As a result of IFED's investigation, he received a police caution, | 0:08:06 | 0:08:10 | |
and he's now got a criminal record. | 0:08:10 | 0:08:12 | |
Justice had been served. | 0:08:12 | 0:08:15 | |
But this case is a stark reminder of how unscrupulous | 0:08:15 | 0:08:18 | |
some people really are. | 0:08:18 | 0:08:20 | |
Whilst most claims are genuine, | 0:08:20 | 0:08:23 | |
it's not uncommon for us to come across examples | 0:08:23 | 0:08:26 | |
of opportunistic fraud like this, where a claimant has | 0:08:26 | 0:08:30 | |
spotted an opportunity in the most trivial of circumstances | 0:08:30 | 0:08:35 | |
to gain for their own personal benefit. | 0:08:35 | 0:08:37 | |
..an opportunist is caught out when his friends and family | 0:08:45 | 0:08:48 | |
fail to side with his story... | 0:08:48 | 0:08:51 | |
The witness evidence indicated that he had actually tried to slide down | 0:08:51 | 0:08:54 | |
the banister, and he hadn't fallen down something that was | 0:08:54 | 0:08:58 | |
defective in any way. | 0:08:58 | 0:09:00 | |
..and a man attempting to cash in from a housing fire | 0:09:00 | 0:09:03 | |
sees his claim go up in smoke. | 0:09:03 | 0:09:06 | |
We actually found that he had only just purchased the property | 0:09:06 | 0:09:10 | |
last year, and therefore was not the legitimate owner of the premises | 0:09:10 | 0:09:15 | |
when it burned down in 2014. | 0:09:15 | 0:09:19 | |
Now, holidays are usually a time for us to relax and soak up the sun, | 0:09:24 | 0:09:28 | |
but if the worst should happen and we become ill, | 0:09:28 | 0:09:31 | |
then medical treatment abroad can be costly. | 0:09:31 | 0:09:34 | |
Travel insurance is there to put our minds at rest, | 0:09:34 | 0:09:37 | |
with policies covering everything from minor ailments | 0:09:37 | 0:09:40 | |
to surgical procedures. | 0:09:40 | 0:09:41 | |
But as if being away on holiday isn't enough of a treat, | 0:09:41 | 0:09:45 | |
there are some people out there who will use the experience | 0:09:45 | 0:09:48 | |
to try and pocket some extra cash at the expense | 0:09:48 | 0:09:51 | |
of their travel insurance policy. | 0:09:51 | 0:09:53 | |
Matthew Crawford-Thomas is a fraud manager at Collinson Group. | 0:09:56 | 0:10:00 | |
His team recently dealt with a claim from a customer | 0:10:02 | 0:10:05 | |
who had unfortunately succumbed to a rather common complaint | 0:10:05 | 0:10:08 | |
when travelling abroad. | 0:10:08 | 0:10:11 | |
We received the claim from the insured for circa £1,400 | 0:10:11 | 0:10:14 | |
for medical expenses whilst in Zimbabwe for sickness and diarrhoea. | 0:10:14 | 0:10:19 | |
As with many other forms of insurance, | 0:10:19 | 0:10:21 | |
before the claim could be processed, | 0:10:21 | 0:10:23 | |
the insurer needed some form of proof that the treatment | 0:10:23 | 0:10:26 | |
had actually taken place. | 0:10:26 | 0:10:28 | |
We asked the administration team to supply us with | 0:10:29 | 0:10:32 | |
the original documentation. | 0:10:32 | 0:10:34 | |
After looking at the scans on our computer system, | 0:10:34 | 0:10:37 | |
it appeared that the documentation had actually been altered. | 0:10:37 | 0:10:40 | |
With his fraud radar on high alert, | 0:10:41 | 0:10:43 | |
Matthew employed a trick of the trade... | 0:10:43 | 0:10:46 | |
..a large magnifying glass known as a linen tester. | 0:10:46 | 0:10:50 | |
Originally used to check the quality of woven fabrics, | 0:10:50 | 0:10:53 | |
they are now used in the insurance industry to allow investigators | 0:10:53 | 0:10:57 | |
to closely examine documents and check they're legitimate. | 0:10:57 | 0:11:00 | |
Upon looking at the documents through the linen tester, | 0:11:01 | 0:11:04 | |
it was evident that additional sums | 0:11:04 | 0:11:06 | |
had been added to the receipts. | 0:11:06 | 0:11:08 | |
The three receipts that we concentrated on mainly | 0:11:09 | 0:11:12 | |
was for a taxi fare for less than seven miles, | 0:11:12 | 0:11:15 | |
yet it was for 200 US dollars. | 0:11:15 | 0:11:18 | |
The second receipt was from the Zimbabwean government, | 0:11:18 | 0:11:21 | |
which clearly was only for 4, and had been written, | 0:11:21 | 0:11:24 | |
"104". | 0:11:24 | 0:11:27 | |
And the third receipt was a receipt from the Zimbabwe hospital, | 0:11:27 | 0:11:31 | |
which after picking the Tippex off, clearly showed an amount of | 0:11:31 | 0:11:34 | |
4 rather than the 150 that she originally claimed for. | 0:11:34 | 0:11:37 | |
Wowzer. That's quite the increase. | 0:11:37 | 0:11:41 | |
It appeared that the amount on all eight receipts the woman had sent | 0:11:41 | 0:11:44 | |
to the insurance company had been altered, | 0:11:44 | 0:11:46 | |
boosting her claim to hundreds of dollars more | 0:11:46 | 0:11:49 | |
than she was entitled to. | 0:11:49 | 0:11:52 | |
It was time to phone the suspected forger | 0:11:52 | 0:11:54 | |
and challenge her on the dodgily doctored receipts. | 0:11:54 | 0:11:57 | |
The customer was insistent that she hadn't doctored the receipts, | 0:13:18 | 0:13:22 | |
yet the insurance company could clearly see that the amounts | 0:13:22 | 0:13:25 | |
on the receipts had been changed. | 0:13:25 | 0:13:28 | |
As far as Collinson were concerned, it was an easy decision. | 0:13:28 | 0:13:31 | |
Despite the strong evidence against her, | 0:13:50 | 0:13:53 | |
this customer still refused to admit the receipts weren't genuine. | 0:13:53 | 0:13:57 | |
So, Matthew and his team dug a little deeper into her past. | 0:13:57 | 0:14:02 | |
Once we'd found out that the insured's claim | 0:14:02 | 0:14:04 | |
was in fact fraudulent, we looked through our system, | 0:14:04 | 0:14:06 | |
and, lo and behold, found another claim for the individual. | 0:14:06 | 0:14:10 | |
We duly then retrieved the documents from our administration department, | 0:14:10 | 0:14:13 | |
and again found these to be doctored. | 0:14:13 | 0:14:17 | |
Just a year previously, the woman had been on another holiday | 0:14:17 | 0:14:21 | |
to Zimbabwe, and had claimed for medical expenses for that trip, too. | 0:14:21 | 0:14:26 | |
Only the first time, she hadn't been so greedy, | 0:14:26 | 0:14:28 | |
and had successfully received a pay-out of nearly £300. | 0:14:28 | 0:14:32 | |
With her first claim also showing signs of fraud, | 0:14:34 | 0:14:37 | |
it was time to share the good news with the claimant, | 0:14:37 | 0:14:39 | |
and take back what she wasn't entitled to. | 0:14:39 | 0:14:42 | |
It had taken a while, but the woman had been well and truly busted. | 0:15:39 | 0:15:44 | |
But incredibly, despite being found out, | 0:15:44 | 0:15:46 | |
she seemed hell-bent on keeping her policy in place, | 0:15:46 | 0:15:50 | |
just in case she wanted to do it again. | 0:15:50 | 0:15:53 | |
In another telephone call, she contacted us to say that | 0:15:53 | 0:15:56 | |
is her policy still valid, as she was going on holiday again? | 0:15:56 | 0:15:59 | |
Yet she'd already said to us that she didn't have enough money | 0:15:59 | 0:16:01 | |
to pay us back, so where she's getting her money from, | 0:16:01 | 0:16:04 | |
God only knows. | 0:16:04 | 0:16:07 | |
The insurers then wrote to the woman, | 0:16:07 | 0:16:09 | |
declining both claims and stating the repayment costs. | 0:16:09 | 0:16:13 | |
They never heard from her again. | 0:16:13 | 0:16:16 | |
The downfall for the insured person on this occasion were the documents. | 0:16:16 | 0:16:20 | |
They were a killer. | 0:16:20 | 0:16:22 | |
My daughter could have completed them considerably better, | 0:16:22 | 0:16:24 | |
and she's eight years old. | 0:16:24 | 0:16:27 | |
This leads me to believe that this was not an opportunistic fraud, | 0:16:27 | 0:16:31 | |
this was a cold, calculated effort to defraud insurers. | 0:16:31 | 0:16:35 | |
With two instances of fraud to her name, | 0:16:36 | 0:16:39 | |
the woman was fortunate to escape prosecution. | 0:16:39 | 0:16:42 | |
Next time, she might not be so lucky. | 0:16:42 | 0:16:44 | |
This type of fraud is not uncommon | 0:16:46 | 0:16:48 | |
within the travel insurance industry, | 0:16:48 | 0:16:50 | |
and I would say to anyone that attempting to make a claim | 0:16:50 | 0:16:53 | |
with my company for this particular type of fraud, | 0:16:53 | 0:16:56 | |
I would say, not on my watch! | 0:16:56 | 0:16:58 | |
Most household insurance claims are genuine. | 0:17:03 | 0:17:06 | |
They should be pretty simple. | 0:17:06 | 0:17:08 | |
The person claiming has suffered a loss | 0:17:08 | 0:17:10 | |
and wants to be compensated for it. | 0:17:10 | 0:17:12 | |
But even when claims start out as honest losses, | 0:17:12 | 0:17:15 | |
some people get carried away, | 0:17:15 | 0:17:17 | |
exaggerating the value of items or adding things to the list | 0:17:17 | 0:17:20 | |
that weren't stolen or damaged in the first place. | 0:17:20 | 0:17:23 | |
In order to settle claims of theft, | 0:17:30 | 0:17:31 | |
insurance companies usually require proof of ownership | 0:17:31 | 0:17:34 | |
such as receipts or guarantees. | 0:17:34 | 0:17:37 | |
But this is where fraudsters are often caught out, | 0:17:37 | 0:17:39 | |
by making simple mistakes that can end up invalidating | 0:17:39 | 0:17:43 | |
their whole claim. | 0:17:43 | 0:17:45 | |
Dave Berry deals with home insurance at Lloyds Banking Group, | 0:17:48 | 0:17:52 | |
and knows only too well that not every claim is entirely above board. | 0:17:52 | 0:17:56 | |
A customer reported that he had taken his dogs out for a walk. | 0:17:58 | 0:18:03 | |
He did that just before he was going to come back home to watch | 0:18:03 | 0:18:06 | |
a live game of football on the telly. | 0:18:06 | 0:18:08 | |
When he got back home, | 0:18:08 | 0:18:10 | |
he saw that his kitchen window had been forced open. | 0:18:10 | 0:18:13 | |
He went into the house, | 0:18:13 | 0:18:15 | |
also found that his patio doors were wide open | 0:18:15 | 0:18:17 | |
and that he'd been burgled. | 0:18:17 | 0:18:19 | |
After police had attended the crime scene, | 0:18:20 | 0:18:22 | |
the customer phoned Lloyds to make a claim. | 0:18:22 | 0:18:25 | |
There was no doubt this was hugely upsetting for the family involved. | 0:19:26 | 0:19:30 | |
Not only had their home been invaded, | 0:19:30 | 0:19:33 | |
but they were now around £15,000 out of pocket. | 0:19:33 | 0:19:37 | |
When we first received the claim, everything appeared in order. | 0:19:39 | 0:19:42 | |
We still needed to go through the process of identifying the value | 0:19:42 | 0:19:46 | |
of the items and their age so that | 0:19:46 | 0:19:48 | |
we could make sure the correct value was placed on the claim. | 0:19:48 | 0:19:51 | |
As is the case with any claim for valuables, | 0:19:53 | 0:19:55 | |
Lloyds needed proof that the family had owned them in the first place. | 0:19:55 | 0:19:59 | |
To help us validate the value of the claim and ownership of the items, | 0:19:59 | 0:20:03 | |
we ask our customers to provide whatever evidence of ownership | 0:20:03 | 0:20:07 | |
they might have retained. That could include manuals for electrical goods | 0:20:07 | 0:20:10 | |
or guarantees. It could include boxes. | 0:20:10 | 0:20:12 | |
It could include photographs, purchase receipts, | 0:20:12 | 0:20:16 | |
bank statements showing that they've paid cash for items, | 0:20:16 | 0:20:19 | |
a whole range of items are available that we will consider | 0:20:19 | 0:20:22 | |
to help us assess the value of the claim. | 0:20:22 | 0:20:26 | |
The customer gathered a variety of receipts and photographs | 0:20:26 | 0:20:29 | |
to give to his insurance company. | 0:20:29 | 0:20:32 | |
As the claim was so large, | 0:20:32 | 0:20:34 | |
Lloyds decided to visit the customer at home to go through the evidence | 0:20:34 | 0:20:38 | |
and put a final value on the items he was claiming for. | 0:20:38 | 0:20:41 | |
Our agents met with the customer, | 0:20:42 | 0:20:44 | |
and were discussing the value of the claim and looking at | 0:20:44 | 0:20:47 | |
the documentation that had been provided to them | 0:20:47 | 0:20:50 | |
in support of the claim. | 0:20:50 | 0:20:52 | |
One of those items was a photograph of the customer wearing a watch, | 0:20:52 | 0:20:55 | |
the watch that had been reported stolen. | 0:20:55 | 0:20:58 | |
The customer hadn't kept the receipt for the watch, | 0:20:58 | 0:21:01 | |
so had provided a photo of him wearing it instead. | 0:21:01 | 0:21:04 | |
But on closer inspection, the agent spotted something | 0:21:04 | 0:21:07 | |
that didn't seem quite right. | 0:21:07 | 0:21:10 | |
In the foreground of that photograph, though, | 0:21:10 | 0:21:12 | |
there was a copy of a newspaper. | 0:21:12 | 0:21:15 | |
Our agent recognised the headlines in that newspaper, | 0:21:15 | 0:21:19 | |
and thought that they were more recent | 0:21:19 | 0:21:22 | |
than the photograph could potentially have been taken. | 0:21:22 | 0:21:25 | |
When they made some enquiries into the date on which | 0:21:25 | 0:21:28 | |
that newspaper headline had appeared, | 0:21:28 | 0:21:30 | |
they had in fact been printed on the 8th of August, | 0:21:30 | 0:21:33 | |
which was some four days after the burglary was said to have occurred. | 0:21:33 | 0:21:37 | |
That indicated to us that because the photograph had been taken | 0:21:39 | 0:21:42 | |
after the burglary, that in fact the watch hasn't been stolen | 0:21:42 | 0:21:45 | |
at the time. | 0:21:45 | 0:21:46 | |
This revelation threw the validity of the entire claim into question. | 0:21:46 | 0:21:51 | |
Had the burglary even taken place, | 0:21:51 | 0:21:53 | |
or was the customer trying to claim for additional items | 0:21:53 | 0:21:56 | |
that hadn't been stolen? | 0:21:56 | 0:21:58 | |
We reported the matter to the insurance fraud enforcement department. | 0:21:58 | 0:22:02 | |
They interviewed the claimant, | 0:22:02 | 0:22:04 | |
and he admitted that he had exaggerated the claim, | 0:22:04 | 0:22:08 | |
that the watch hadn't been stolen, and as a result of that admission, | 0:22:08 | 0:22:13 | |
IFED agreed to deal with the matter by way of a police caution. | 0:22:13 | 0:22:16 | |
Many cases of insurance fraud start out as genuine claims, | 0:22:18 | 0:22:22 | |
but when some people see an opportunity to cash in, | 0:22:22 | 0:22:25 | |
the temptation to exaggerate their claim for a bumper pay-out | 0:22:25 | 0:22:29 | |
is just too great to resist. | 0:22:29 | 0:22:31 | |
It is possible that customers who do submit a fraudulent claim | 0:22:33 | 0:22:37 | |
don't realise that if they're caught, | 0:22:37 | 0:22:39 | |
there could be serious repercussions. | 0:22:39 | 0:22:41 | |
It could mean that their policy's cancelled. | 0:22:41 | 0:22:43 | |
It could mean the matter's reported to the police, | 0:22:43 | 0:22:45 | |
and if it is reported to the police, | 0:22:45 | 0:22:47 | |
that could result in either a custodial sentence, | 0:22:47 | 0:22:49 | |
a police caution, and on a longer term basis, | 0:22:49 | 0:22:52 | |
make it more difficult to secure financial products. | 0:22:52 | 0:22:55 | |
Accidents are part and parcel of everyday life. | 0:23:01 | 0:23:04 | |
In some cases, it genuinely isn't our fault - | 0:23:04 | 0:23:07 | |
a wet floor without a hazard sign, | 0:23:07 | 0:23:09 | |
or a trailing cable across a walkway. | 0:23:09 | 0:23:12 | |
Of course, sometimes we only have ourselves to blame. | 0:23:12 | 0:23:15 | |
However, there are some unscrupulous people out there who think | 0:23:15 | 0:23:18 | |
they can cheat the system by pointing the finger | 0:23:18 | 0:23:21 | |
in the wrong direction. | 0:23:21 | 0:23:23 | |
Nowadays, insurance companies have a plethora of hi-tech tools | 0:23:25 | 0:23:29 | |
at their disposal to combat spurious claims, | 0:23:29 | 0:23:33 | |
but sometimes it's good old-fashioned eyewitness accounts | 0:23:33 | 0:23:36 | |
that separate the wheat from the chaff | 0:23:36 | 0:23:38 | |
when it comes to solving tricky cases. | 0:23:38 | 0:23:40 | |
Ben McBean is a claims controller at insurance company QBE, | 0:23:43 | 0:23:47 | |
and recently dealt with a case where a night out went disastrously wrong. | 0:23:47 | 0:23:51 | |
The first thing we received on this claim were allegations | 0:23:53 | 0:23:56 | |
from the claimant that he was a visitor | 0:23:56 | 0:23:59 | |
to our insured nightclub's premises. | 0:23:59 | 0:24:01 | |
As he was descending the stairs, because the banister was so low, | 0:24:07 | 0:24:11 | |
he actually fell over the banister, and he fell a height of about | 0:24:11 | 0:24:15 | |
24 feet, straight to the ground. | 0:24:15 | 0:24:18 | |
The injuries that he sustained as a result of the fall | 0:24:23 | 0:24:25 | |
were a broken hip, | 0:24:25 | 0:24:28 | |
a fractured pelvis, | 0:24:28 | 0:24:31 | |
various broken ribs, and potentially a fractured leg. | 0:24:31 | 0:24:35 | |
He said that he could be in hospital for four months, | 0:24:36 | 0:24:39 | |
and obviously he wouldn't be able to work during this time. | 0:24:39 | 0:24:43 | |
A devastating accident, | 0:24:43 | 0:24:45 | |
and the last thing you'd expect to happen on a night out. | 0:24:45 | 0:24:49 | |
At first glance, it seemed like a legitimate claim. | 0:24:49 | 0:24:52 | |
Somebody who'd fallen a significant height | 0:24:52 | 0:24:54 | |
and sustain some really serious injuries. | 0:24:54 | 0:24:57 | |
Initially, we reserved £30,000 against the claim for the costs | 0:24:57 | 0:25:01 | |
and potential damages that we may have to pay out. | 0:25:01 | 0:25:04 | |
As it was a significant claim, QBE started to investigate, | 0:25:06 | 0:25:10 | |
and asked the claimant for proof to back up his story. | 0:25:10 | 0:25:13 | |
The evidence that the claimant provided was by way of | 0:25:15 | 0:25:18 | |
medical experts' reports, | 0:25:18 | 0:25:19 | |
and also he got engineering evidence to look mainly at the set-up | 0:25:19 | 0:25:24 | |
in the nightclub, whether the handrail for the banister, | 0:25:24 | 0:25:27 | |
whether that was the right height, and whether there were any defects. | 0:25:27 | 0:25:31 | |
QBE also carried out some detective work of their own, | 0:25:32 | 0:25:36 | |
and contacted the nightclub where the incident took place | 0:25:36 | 0:25:39 | |
to see if their account of the fall matched the claimant's. | 0:25:39 | 0:25:42 | |
The manager of the venue completed an accident report form | 0:25:44 | 0:25:48 | |
that he sent to us, which informed us that at the scene, | 0:25:48 | 0:25:52 | |
the claimant had actually apologised | 0:25:52 | 0:25:55 | |
for causing such a hassle. | 0:25:55 | 0:25:57 | |
You wouldn't really expect somebody who had sustained | 0:26:00 | 0:26:03 | |
really significant injuries to first think of apologising | 0:26:03 | 0:26:06 | |
for causing hassle to the owner of a nightclub. | 0:26:06 | 0:26:09 | |
It's certainly not the reaction you'd expect, | 0:26:11 | 0:26:14 | |
but it was when QBE were presented with the witness accounts | 0:26:14 | 0:26:17 | |
that the man's story really hit the skids. | 0:26:17 | 0:26:20 | |
The witness evidence from the accident scene indicated | 0:26:21 | 0:26:25 | |
that he'd actually try to slide down the banister, | 0:26:25 | 0:26:28 | |
and he hadn't fallen down something | 0:26:28 | 0:26:30 | |
that was defective in any way. | 0:26:30 | 0:26:32 | |
Essentially, the whole case comes down to whether he slid down | 0:26:37 | 0:26:40 | |
the banister or whether he fell because it was defective, | 0:26:40 | 0:26:43 | |
either there was a fault with it or it wasn't constructed | 0:26:43 | 0:26:46 | |
at the right height to start with. | 0:26:46 | 0:26:48 | |
They is a world of difference between a faulty banister | 0:26:50 | 0:26:54 | |
and a schoolboy prank gone wrong. | 0:26:54 | 0:26:57 | |
Obviously, once we'd identified that potentially we were dealing with | 0:26:57 | 0:27:00 | |
someone who may have lied to us, | 0:27:00 | 0:27:02 | |
we had to do some social media investigation. | 0:27:02 | 0:27:05 | |
On doing that, we'd identified quite a few comments from his friends | 0:27:08 | 0:27:11 | |
and family around his judgment being poor, | 0:27:11 | 0:27:15 | |
that he'd actually slid down the banister instead of fallen, | 0:27:15 | 0:27:19 | |
and they'd also called him various names such as muppet, | 0:27:19 | 0:27:22 | |
cretin and various other expletives. | 0:27:22 | 0:27:25 | |
With the evidence on social media backing up the eyewitness accounts, | 0:27:26 | 0:27:30 | |
QBE had no doubt that they were dealing with a fraudulent claim. | 0:27:30 | 0:27:34 | |
We decided we had sufficient evidence to run this to trial, | 0:27:37 | 0:27:40 | |
so we indicated to the claimant and his legal representatives | 0:27:40 | 0:27:44 | |
that we were going to defend it, | 0:27:44 | 0:27:46 | |
and produced the evidence that we had. | 0:27:46 | 0:27:49 | |
Surprisingly, they still decided to continue to trial with it. | 0:27:49 | 0:27:52 | |
Once the case had reached court, | 0:27:54 | 0:27:56 | |
yet more damning evidence came out of the woodwork. | 0:27:56 | 0:27:59 | |
At trial, quite interestingly, | 0:28:01 | 0:28:03 | |
we identified that there were A&E records which indicated | 0:28:03 | 0:28:07 | |
he'd actually slid down the banister, | 0:28:07 | 0:28:09 | |
which the claimant contested. | 0:28:09 | 0:28:11 | |
He said that maybe somebody had just made that up, | 0:28:11 | 0:28:14 | |
and hadn't recorded precisely what he actually said. | 0:28:14 | 0:28:18 | |
Right. So, with the eyewitness accounts, | 0:28:18 | 0:28:21 | |
his friends and family on social media | 0:28:21 | 0:28:24 | |
and now the A&E records all saying | 0:28:24 | 0:28:26 | |
the claimant had slid down the banister, | 0:28:26 | 0:28:29 | |
it'll come as no surprise that the judge was reluctant | 0:28:29 | 0:28:33 | |
to give him the benefit of the doubt. | 0:28:33 | 0:28:35 | |
The judge said of the claimant that he didn't believe | 0:28:36 | 0:28:40 | |
that his recollection was a true account of what actually happened, | 0:28:40 | 0:28:43 | |
and that was being quite charitable to him. | 0:28:43 | 0:28:46 | |
The claim was struck out of court, | 0:28:46 | 0:28:48 | |
and this chancer's attempt to cash in on his own recklessness | 0:28:48 | 0:28:51 | |
had well and truly crashed out. | 0:28:51 | 0:28:54 | |
QBE were very pleased with the outcome from the trial because, | 0:28:57 | 0:29:00 | |
whilst unfortunately somebody sustained | 0:29:00 | 0:29:03 | |
quite significant injuries, which we would never wish upon anyone, | 0:29:03 | 0:29:06 | |
you can't allow people just to point blame at innocent people | 0:29:06 | 0:29:10 | |
who aren't responsible. | 0:29:10 | 0:29:13 | |
Sadly, claims like this are becoming more and more common, | 0:29:13 | 0:29:17 | |
and it's honest policyholders that end up paying the price, | 0:29:17 | 0:29:20 | |
as insurers are forced to pass on the cost of dishonest claims | 0:29:20 | 0:29:23 | |
in the form of increased premiums. | 0:29:23 | 0:29:26 | |
Unfortunately, all the media used by solicitors | 0:29:27 | 0:29:31 | |
to create this whole "where there's blame, there's a claim" mentality | 0:29:31 | 0:29:35 | |
has created what ends up being a lot of fraudulent claims. | 0:29:35 | 0:29:39 | |
And insurers are spending a lot of time and money to defend them. | 0:29:39 | 0:29:43 | |
Still to come, a bus passenger fails to get his facts straight | 0:29:49 | 0:29:53 | |
when making a personal injury claim. | 0:29:53 | 0:29:56 | |
Shy of an American wrestler boarding the bus and body-slamming | 0:29:56 | 0:29:59 | |
the claimant to the floor, it couldn't have been | 0:29:59 | 0:30:01 | |
a lot more different to what we were told. | 0:30:01 | 0:30:03 | |
Buying property is a tricky and expensive business, | 0:30:07 | 0:30:11 | |
but if you play your cards right, | 0:30:11 | 0:30:13 | |
it can save you a lot of money in the long run. | 0:30:13 | 0:30:16 | |
Buildings insurance is usually put in place from the date of exchange, | 0:30:16 | 0:30:19 | |
and is there to protect the owner or owners should the property | 0:30:19 | 0:30:22 | |
fall victim to a fire or flood. | 0:30:22 | 0:30:25 | |
The good news is if your property is damaged, you're usually covered. | 0:30:25 | 0:30:29 | |
The bad news is some scammers see this | 0:30:29 | 0:30:32 | |
as an easy way of cashing in | 0:30:32 | 0:30:34 | |
by pretending they're the legal owner of a property | 0:30:34 | 0:30:37 | |
when in fact they never completed their purchase. | 0:30:37 | 0:30:40 | |
RSA is an insurance company that provides everything | 0:30:41 | 0:30:44 | |
from home and pet insurance | 0:30:44 | 0:30:47 | |
to policies for multinational businesses. | 0:30:47 | 0:30:49 | |
John Beadle is head of financial crime and counter fraud there, | 0:30:51 | 0:30:55 | |
and recently handled a case with an audacious individual. | 0:30:55 | 0:30:58 | |
A gentleman successfully bought a house | 0:30:59 | 0:31:03 | |
at auction for £35,000. | 0:31:03 | 0:31:05 | |
He paid a 10% deposit, £3,500, | 0:31:07 | 0:31:11 | |
and insured the house with us at RSA. | 0:31:11 | 0:31:15 | |
Unfortunately, six days after he purchased the house, | 0:31:15 | 0:31:19 | |
there was a catastrophic fire | 0:31:19 | 0:31:20 | |
at the premises, which virtually gutted it. | 0:31:20 | 0:31:25 | |
A fire is a homeowner's worst nightmare. | 0:31:27 | 0:31:30 | |
But it's times like these where a house insurance policy | 0:31:31 | 0:31:34 | |
can really come to the rescue. | 0:31:34 | 0:31:36 | |
The claim was originally registered with us | 0:31:38 | 0:31:41 | |
by this gentleman under his household policy, | 0:31:41 | 0:31:45 | |
but the sale actually didn't go through, | 0:31:45 | 0:31:49 | |
and he had his £3,500 deposit | 0:31:49 | 0:31:52 | |
he'd paid the auction house refunded, | 0:31:52 | 0:31:56 | |
and he withdrew the claim. | 0:31:56 | 0:31:58 | |
A lucky escape that thankfully hadn't left the man out of pocket. | 0:31:59 | 0:32:03 | |
RSA assumed they would hear nothing more from their customer, | 0:32:04 | 0:32:08 | |
and closed the files on the case. | 0:32:08 | 0:32:10 | |
As far as we were concerned, that was the end of the matter. | 0:32:12 | 0:32:16 | |
Um, but we were quite surprised when, | 0:32:16 | 0:32:19 | |
some two years later, | 0:32:19 | 0:32:22 | |
the gentleman then resurrected his claim, | 0:32:22 | 0:32:27 | |
which had now been set at £78,000 | 0:32:27 | 0:32:32 | |
for complete refurbishment of the premises. | 0:32:32 | 0:32:36 | |
Now, the last time RSA had heard from the man, | 0:32:37 | 0:32:40 | |
his purchase of the property had fallen through, and he walked away. | 0:32:40 | 0:32:44 | |
So, how could he be claiming on it now? | 0:32:44 | 0:32:48 | |
This seemed rather strange, | 0:32:48 | 0:32:50 | |
to have heard nothing for two years, | 0:32:50 | 0:32:53 | |
and then have this claim for this | 0:32:53 | 0:32:55 | |
vast amount of money restated. | 0:32:55 | 0:32:58 | |
So, we began looking into the circumstances. | 0:32:58 | 0:33:01 | |
RSA checked the Land Registry records for the property | 0:33:02 | 0:33:05 | |
to see whether the claimant had actually been the legal owner | 0:33:05 | 0:33:09 | |
when the fire took place. | 0:33:09 | 0:33:10 | |
We've actually found that he had | 0:33:12 | 0:33:14 | |
only just purchased the property last year, | 0:33:14 | 0:33:18 | |
and therefore was not the legitimate owner of the premises | 0:33:18 | 0:33:21 | |
when it burned down in 2014. | 0:33:21 | 0:33:25 | |
RSA discover that their customer had purchased the damage property | 0:33:27 | 0:33:31 | |
two years after the fire at a reduced price of just £18,000, | 0:33:31 | 0:33:36 | |
yet here he was claiming £78,000 refurbishment. | 0:33:36 | 0:33:41 | |
Now, as we all know, insurance doesn't work like that, | 0:33:44 | 0:33:47 | |
and because the man didn't own the property at the time of the blaze, | 0:33:47 | 0:33:51 | |
he wasn't entitled to claim for the damage caused by it. | 0:33:51 | 0:33:54 | |
Put simply, | 0:33:55 | 0:33:58 | |
we didn't pay the claim, and had no intention of doing so, | 0:33:58 | 0:34:03 | |
and this gentleman will have to fund | 0:34:03 | 0:34:06 | |
the refurbishment of the house | 0:34:06 | 0:34:08 | |
that he's purchased out of his own funds. | 0:34:08 | 0:34:11 | |
Sounds fair enough to me, | 0:34:11 | 0:34:13 | |
but the sad reality is that when it comes to insurance cheats, | 0:34:13 | 0:34:16 | |
what's fair and right simply doesn't come into it. | 0:34:16 | 0:34:20 | |
But as this case demonstrates, | 0:34:20 | 0:34:22 | |
insurers are not a soft touch. | 0:34:22 | 0:34:26 | |
I think this was probably quite calculated | 0:34:26 | 0:34:30 | |
in the sense that when he did purchase the house, | 0:34:30 | 0:34:34 | |
now for a much reduced cost | 0:34:34 | 0:34:36 | |
because of the extent of the damage to it, | 0:34:36 | 0:34:39 | |
he thought he could just simply resurrect a two-year-old claim, | 0:34:39 | 0:34:43 | |
and that we would just pay that claim without any sort of checks. | 0:34:43 | 0:34:48 | |
Of course, he soon learned that, actually, | 0:34:48 | 0:34:51 | |
a simple check at the Land Registry would show | 0:34:51 | 0:34:54 | |
that he wasn't the owner of the premises. | 0:34:54 | 0:34:57 | |
As John explains, dishonest and opportunistic claims like these | 0:34:58 | 0:35:02 | |
affect all of us. | 0:35:02 | 0:35:04 | |
The point I'm trying to get across to people is | 0:35:04 | 0:35:07 | |
if you have a genuine claim, | 0:35:07 | 0:35:09 | |
we want to help you to get back on your feet, | 0:35:09 | 0:35:13 | |
or reinstate your damaged or your lost property | 0:35:13 | 0:35:17 | |
as quickly as possible. | 0:35:17 | 0:35:19 | |
People who try and invent claims | 0:35:19 | 0:35:22 | |
or exaggerate claims | 0:35:22 | 0:35:26 | |
just cause us a lot of time, | 0:35:26 | 0:35:29 | |
trouble and effort, | 0:35:29 | 0:35:31 | |
and of course cost us money, | 0:35:31 | 0:35:33 | |
which ultimately impacts all our honest customers. | 0:35:33 | 0:35:36 | |
So, my message is don't do it. | 0:35:36 | 0:35:38 | |
You'll get caught. | 0:35:38 | 0:35:40 | |
And leave us alone to service our honest customers. | 0:35:40 | 0:35:43 | |
Now, with Britain's roads getting more and more crowded, | 0:35:48 | 0:35:51 | |
many of us are turning to public transport to get around. | 0:35:51 | 0:35:54 | |
So, it's no wonder that over 12 million bus journeys | 0:35:54 | 0:35:57 | |
are made in the UK every day. | 0:35:57 | 0:36:00 | |
But the last thing we expect when we hop on board | 0:36:00 | 0:36:03 | |
is to end up sustaining an injury. | 0:36:03 | 0:36:05 | |
In the event that an accident does occur, | 0:36:08 | 0:36:11 | |
most buses are now fitted with CCTV cameras, | 0:36:11 | 0:36:14 | |
which can provide crucial evidence. | 0:36:14 | 0:36:17 | |
They're often used to prove genuine claims are just that, | 0:36:17 | 0:36:21 | |
but they also play a vital role in identifying the claims | 0:36:21 | 0:36:24 | |
which aren't so clear-cut. | 0:36:24 | 0:36:26 | |
Lee Ingram at First Group knows only too well how important CCTV can be, | 0:36:29 | 0:36:34 | |
especially in cases where it's one person's word against another. | 0:36:34 | 0:36:38 | |
This was a claim that was submitted to us by a firm of solicitors | 0:36:40 | 0:36:43 | |
on behalf of a couple that had boarded one of our buses. | 0:36:43 | 0:36:46 | |
It was a disabled couple, a lady in a wheelchair, a guy with a stick. | 0:36:46 | 0:36:50 | |
They've got on the bus. | 0:36:50 | 0:36:52 | |
He's helped his wife to the disabled and buggy access area. | 0:36:52 | 0:36:56 | |
He's then gone back to scan his ticket, and as he's walking | 0:36:56 | 0:36:58 | |
back to his seat, he's saying that the bus has pulled away, | 0:36:58 | 0:37:01 | |
causing him to fall over and hit his head off one of the seats. | 0:37:01 | 0:37:04 | |
When the claim was reported through to our customer services, | 0:37:06 | 0:37:10 | |
his partner had advised that he'd sustained a cut to his eye. | 0:37:10 | 0:37:14 | |
Now, we did a follow-up call from our customer services, | 0:37:14 | 0:37:17 | |
and at that time, we were told that the day after the accident, | 0:37:17 | 0:37:20 | |
he'd actually been admitted to hospital following difficulty | 0:37:20 | 0:37:23 | |
standing and speaking. | 0:37:23 | 0:37:25 | |
So, he'd been taken in with a concussion, a severe concussion, | 0:37:25 | 0:37:28 | |
and kept in for a week. | 0:37:28 | 0:37:30 | |
So, some quite serious injuries at that time. | 0:37:30 | 0:37:33 | |
First Group take passenger safety incredibly seriously, | 0:37:34 | 0:37:38 | |
and with a nasty injury to one of their passengers, | 0:37:38 | 0:37:41 | |
they were potentially facing a five figure pay-out. | 0:37:41 | 0:37:44 | |
This claim would have been valued in the region of £10,000, | 0:37:46 | 0:37:50 | |
including the injuries themselves | 0:37:50 | 0:37:52 | |
and the legal costs for pursuing the claim. | 0:37:52 | 0:37:55 | |
From the facts that Lee had been given, | 0:37:55 | 0:37:57 | |
this appeared to be a clear-cut case. | 0:37:57 | 0:38:00 | |
There are safety protocols in place to protect passengers, | 0:38:00 | 0:38:02 | |
and if they'd been broken, then First Group were liable. | 0:38:02 | 0:38:05 | |
Initial indication would suggest that this was a legitimate claim. | 0:38:09 | 0:38:12 | |
The bus driver should really have waited for any people | 0:38:12 | 0:38:15 | |
with disabilities to be seated before they pull away. | 0:38:15 | 0:38:18 | |
It's definitely something that we would want to look into | 0:38:18 | 0:38:20 | |
for that reason alone. | 0:38:20 | 0:38:22 | |
Lee's first port of call was to contact the bus driver. | 0:38:24 | 0:38:28 | |
When we asked our driver for their version of what actually happened, | 0:38:28 | 0:38:31 | |
the driver said, | 0:38:31 | 0:38:33 | |
"I don't recall actually moving away | 0:38:33 | 0:38:36 | |
"from that stop when that person fell over." | 0:38:36 | 0:38:40 | |
With the disabled passenger claiming the bus had driven off | 0:38:41 | 0:38:44 | |
and the bus driver alleging the bus had remained stationary, | 0:38:44 | 0:38:47 | |
there was only one way of finding out whose account was the real one. | 0:38:47 | 0:38:52 | |
You've guessed it - CCTV. | 0:38:52 | 0:38:54 | |
But while the bus's trusty all-seeing eye has been | 0:38:57 | 0:39:00 | |
the deciding factor in hundreds of claims over the years, | 0:39:00 | 0:39:03 | |
even a veteran like Lee was surprised by this case. | 0:39:03 | 0:39:06 | |
When I looked at the CCTV on this one, | 0:39:08 | 0:39:11 | |
it's a little bit of an eye-opener. | 0:39:11 | 0:39:13 | |
Shy of an American wrestler boarding the bus and body-slamming | 0:39:13 | 0:39:16 | |
the claimant to the floor, | 0:39:16 | 0:39:18 | |
it couldn't have been a lot more different to what we were told. | 0:39:18 | 0:39:21 | |
So, we can see the couple now, that they do board the bus. | 0:39:23 | 0:39:27 | |
She goes to sit down in the disabled area. | 0:39:27 | 0:39:30 | |
He's telling us that he's scanned his ticket, gone to sit down. | 0:39:32 | 0:39:35 | |
He's clearly forgotten lesson 101 on how to sit on a chair properly, | 0:39:43 | 0:39:47 | |
and he's failed spectacularly. | 0:39:47 | 0:39:50 | |
He's fallen off, spun round, | 0:39:51 | 0:39:53 | |
hit his head off the chair opposite. | 0:39:53 | 0:39:56 | |
Getting up, he's managed to hit his head again on the chair behind. | 0:39:56 | 0:39:59 | |
So, quite a serious fall indeed, | 0:40:03 | 0:40:05 | |
but if you look at the footage again... | 0:40:05 | 0:40:07 | |
..there's a rather large inconsistency | 0:40:09 | 0:40:11 | |
with the claimant's version of events... | 0:40:11 | 0:40:15 | |
..and that's putting it mildly, | 0:40:15 | 0:40:17 | |
because the bus is stationary the entire time. | 0:40:17 | 0:40:20 | |
He's clearly injured, and you can see how he's been injured, | 0:40:22 | 0:40:24 | |
but to say that's caused by the bus pulling away | 0:40:24 | 0:40:27 | |
is outrageous. | 0:40:27 | 0:40:30 | |
There is no way that the bus has moved. | 0:40:30 | 0:40:33 | |
That's not what caused him to fall at all. | 0:40:33 | 0:40:35 | |
It's the fact that he can't sit on a chair properly. | 0:40:35 | 0:40:37 | |
Based on what we'd seen in the CCTV footage | 0:40:40 | 0:40:43 | |
and what our driver had told us, | 0:40:43 | 0:40:45 | |
we can only conclude that this was an unfortunate accident, | 0:40:45 | 0:40:49 | |
and that this claimant was making an opportunist attempt | 0:40:49 | 0:40:52 | |
to make a claim for compensation | 0:40:52 | 0:40:55 | |
just because they've fallen over on the bus. | 0:40:55 | 0:40:57 | |
We're not going to pay those sorts of claims. | 0:40:57 | 0:40:59 | |
You need to show that someone has been negligent to be successful. | 0:40:59 | 0:41:04 | |
There was no negligence in this incident at all. | 0:41:04 | 0:41:06 | |
With evidence as compelling as this, | 0:41:07 | 0:41:09 | |
weighing up what to do with this claim | 0:41:09 | 0:41:12 | |
was one of the easiest decisions of Lee's career. | 0:41:12 | 0:41:15 | |
The CCTV, hand-in-hand with the driver's statement | 0:41:18 | 0:41:21 | |
clearly saying that she hadn't moved away, | 0:41:21 | 0:41:24 | |
causing this person to fall over, | 0:41:24 | 0:41:26 | |
makes it really easy to repudiate claims like this. | 0:41:26 | 0:41:29 | |
We sent the CCTV to the claimant's solicitors. | 0:41:29 | 0:41:32 | |
A week later, we received a letter from them saying | 0:41:32 | 0:41:35 | |
that they closed their file. | 0:41:35 | 0:41:37 | |
We never heard again from the claimant, and to be honest, | 0:41:37 | 0:41:40 | |
we don't expect to. | 0:41:40 | 0:41:42 | |
In light of the evidence, I'd say that's a fair assumption. | 0:41:42 | 0:41:46 | |
They say the camera never lies, but in this case, | 0:41:46 | 0:41:49 | |
it had actually exposed their lies. | 0:41:49 | 0:41:52 | |
I'm happy with the result of this particular case. | 0:41:54 | 0:41:57 | |
Not only did we not pay the claim anyway, | 0:41:57 | 0:41:59 | |
because we shouldn't have paid it, | 0:41:59 | 0:42:01 | |
these circumstances were preposterous, | 0:42:01 | 0:42:04 | |
but we've been in a position to support our driver and back her up, | 0:42:04 | 0:42:08 | |
because she did absolutely nothing wrong. | 0:42:08 | 0:42:10 | |
It's not nice to be investigated, and she's been exonerated, | 0:42:10 | 0:42:14 | |
quite rightly so. | 0:42:14 | 0:42:15 | |
But as satisfying as it is to crack cases like these, | 0:42:17 | 0:42:20 | |
it also highlights the depths some people will go | 0:42:20 | 0:42:23 | |
in the hope of some easy money. | 0:42:23 | 0:42:27 | |
These sorts of claims are ridiculous. | 0:42:27 | 0:42:30 | |
To allege something has happened that is clearly different | 0:42:30 | 0:42:33 | |
to what's actually happened just so you can make a claim | 0:42:33 | 0:42:36 | |
is actually disgraceful. | 0:42:36 | 0:42:38 | |
People shouldn't be allowed to get away with this, | 0:42:38 | 0:42:40 | |
which is why we investigate claims the way we do. | 0:42:40 | 0:42:43 | |
We will eventually find out that you're not telling the truth. | 0:42:43 | 0:42:46 | |
We're going to turn your claim down, and on occasion, | 0:42:46 | 0:42:48 | |
we will send these off for prosecution as well. | 0:42:48 | 0:42:51 | |
Insurance fraud in this country costs all of us money, | 0:42:55 | 0:42:59 | |
but the days of no-questions-asked pay-outs are numbered. | 0:42:59 | 0:43:02 | |
Insurers are using ever more sophisticated technology | 0:43:02 | 0:43:06 | |
to identify, track and prosecute fraudsters, | 0:43:06 | 0:43:09 | |
and courts are using new powers | 0:43:09 | 0:43:11 | |
to put these criminals behind bars. | 0:43:11 | 0:43:15 |