Episode 9

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0:00:02 > 0:00:04TYRES SCREECH

0:00:06 > 0:00:10Insurance fraud in the UK has hit epidemic levels.

0:00:10 > 0:00:14It's costing us more than £1.3 billion every year.

0:00:14 > 0:00:19That's almost £3.6 million every day.

0:00:19 > 0:00:25Deliberate crashes, bogus personal injuries, even phantom pets...

0:00:25 > 0:00:28The fraudsters are risking more and more to make a quick killing

0:00:28 > 0:00:33and every year it's adding around £50 to your insurance bill.

0:00:33 > 0:00:36But insurers are fighting back,

0:00:36 > 0:00:39exposing just under 15 fake claims every hour.

0:00:39 > 0:00:41Armed with covert surveillance systems...

0:00:41 > 0:00:44That's the subject out the vehicle.

0:00:44 > 0:00:48..sophisticated data analysis techniques...

0:00:48 > 0:00:49Police!

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

0:00:51 > 0:00:54Police, don't move, stay where you are!

0:00:54 > 0:00:57- ..they're catching the criminals red-handed.- Just don't lie to us!

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

0:00:59 > 0:01:03scammers and cheats on the fiddle are now caught in the act and

0:01:03 > 0:01:05Claimed and Shamed.

0:01:10 > 0:01:15A claimant is given a crash course in fraud.

0:01:28 > 0:01:32Undercover filming exposes an insurance cheat.

0:01:32 > 0:01:37There was absolutely no way that this claimant could deny any of this

0:01:37 > 0:01:40footage that it wasn't him, that it didn't relate to him,

0:01:40 > 0:01:42and that he hadn't committed fraud.

0:01:42 > 0:01:45And a gang that risked the lives of innocent

0:01:45 > 0:01:48motorists is brought to justice.

0:01:48 > 0:01:52The overall financial benefit to those involved was in

0:01:52 > 0:01:54the region of £1.1 million.

0:01:59 > 0:02:05Now, a good catch up with old friends can make for a great night out.

0:02:05 > 0:02:08The problem with that is they can get a bit messy.

0:02:08 > 0:02:11Now, apart from feeling a bit fuzzy the next morning,

0:02:11 > 0:02:15often the biggest headache is realising you have lost something.

0:02:15 > 0:02:18One of the easiest things to lose is your mobile phone.

0:02:20 > 0:02:24Fortunately, there are insurance policies specially designed for

0:02:24 > 0:02:26mobiles and other hand-held devices.

0:02:28 > 0:02:31Assurant offer exactly that and recently dealt with a case from what

0:02:31 > 0:02:36can only be described as a party-loving policyholder.

0:02:36 > 0:02:39So this claimant was a university graduate.

0:02:39 > 0:02:42They'd lost the phone when they were out with their friends

0:02:42 > 0:02:45celebrating, having a reunion.

0:02:45 > 0:02:50They were claiming for a top of the range iPhone 7, which would have

0:02:50 > 0:02:52a retail value of about £600.

0:03:08 > 0:03:13She was very jovial and very chatty about the circumstances of the loss.

0:03:13 > 0:03:16But in addition to her carefree attitude,

0:03:16 > 0:03:20she also had a rather impressive explanation of how she had lost her phone.

0:03:41 > 0:03:44Well, it certainly gives a new meaning to bottoms up.

0:03:44 > 0:03:48She was telling our trained agents about the fact that that she

0:03:48 > 0:03:50then logged on to Find My iPhone.

0:03:50 > 0:03:54She was following it to a street but ultimately, you know, she felt that

0:03:54 > 0:03:55somebody had taken the phone.

0:04:15 > 0:04:17It sounded like an eventful evening.

0:04:17 > 0:04:20But having lost a top of the range smartphone,

0:04:20 > 0:04:22a hangover was the least of the claimant's worries.

0:04:24 > 0:04:27At this point, while she was telling us this great story,

0:04:27 > 0:04:32there was nothing that would lead us to believe it was a fraudulent claim at this stage.

0:04:32 > 0:04:36However, as the claims handler went through the details of the loss,

0:04:36 > 0:04:38something rather unusual came to light.

0:04:38 > 0:04:44What was strange in this case was that the actual phone that the

0:04:44 > 0:04:46particular claimant had,

0:04:46 > 0:04:51they'd only updated their details one or two hours before the incident had occurred.

0:04:51 > 0:04:56To lose a phone just two hours after insuring it really is unlucky.

0:04:56 > 0:04:59So Assurant call the claimant for another chat.

0:05:32 > 0:05:37So it appeared the claimant's cautiousness had saved her from a very expensive night out.

0:05:37 > 0:05:42But as the claim was processed, alarm bells started to ring.

0:05:42 > 0:05:47Our expert fraud team and our data analytics team rather surprisingly

0:05:47 > 0:05:49discovered, through social media,

0:05:49 > 0:05:54a tweet that this particular claimant had put out the night

0:05:54 > 0:05:56before on social media.

0:05:56 > 0:06:00Now, ordinarily, sharing what you're up to online isn't a problem.

0:06:00 > 0:06:04But in this instance, it was a very big problem.

0:06:04 > 0:06:09The reason that this particular tweet was incriminating was the fact

0:06:09 > 0:06:14that it had happened before she had gone out on her all-day drinking and

0:06:14 > 0:06:18the tweet had said she'd actually lost the handset the night before.

0:06:19 > 0:06:22Unless the claimant had a rational explanation,

0:06:22 > 0:06:24then her drink wasn't the only thing on the rocks.

0:07:25 > 0:07:28So, it had been a heady cocktail of lies.

0:07:28 > 0:07:31But the claimant had been rumbled.

0:07:31 > 0:07:36It became clear that she felt she wasn't committing fraud.

0:07:36 > 0:07:41She felt that she could claim for a completely different device

0:07:41 > 0:07:45with a much greater value than her original policy details.

0:07:45 > 0:07:46In reality, it was very naive.

0:07:47 > 0:07:51It was a huge error of judgment on the claimant's part.

0:07:51 > 0:07:54And by the end of the phone call, she really would need a stiff drink.

0:08:27 > 0:08:30As conversations with insurance companies go,

0:08:30 > 0:08:33it was a pretty sobering one.

0:08:33 > 0:08:39Whilst we can all sympathise and relate to what happens on all-day

0:08:39 > 0:08:44drinking sessions with our friends, and potentially losing our devices,

0:08:44 > 0:08:51we were pleased that the claimant in this case was honest and admitted

0:08:51 > 0:08:53that they had attempted to defraud us.

0:08:53 > 0:09:00I'm pretty confident that she will not be attempting to commit fraud again.

0:09:01 > 0:09:06The claimant in this case was extremely fortunate that the matter wasn't taken any further.

0:09:06 > 0:09:10However, this is a cautionary tale that applies to all of us who have

0:09:10 > 0:09:12insurance policies like this one.

0:09:12 > 0:09:17What's really important is to consistently make sure that as you

0:09:17 > 0:09:21change your devices and phones, and buy the latest and greatest,

0:09:21 > 0:09:23just make sure the policy is up-to-date.

0:09:32 > 0:09:35A fraudster's attempt at forgery is foiled.

0:09:35 > 0:09:38When we then checked with the store itself,

0:09:38 > 0:09:42they told us that the receipts were in fact fraudulent and didn't

0:09:42 > 0:09:44come from them.

0:09:49 > 0:09:53Now, opportunistic insurance fraudsters who might add a few items

0:09:53 > 0:09:56to their claim form or say that what they're claiming for cost more than

0:09:56 > 0:09:58it actually did, is one thing.

0:09:58 > 0:10:02But what's really frightening is when you hear about insurance fraud

0:10:02 > 0:10:04carried out by organised gangs.

0:10:04 > 0:10:07One of the most common types is crash for cash.

0:10:12 > 0:10:16There are genuine accidents on the UK's roads every day.

0:10:16 > 0:10:20But crash for cash is when cars driven by fraudsters work together

0:10:20 > 0:10:22to deliberately cause collisions.

0:10:24 > 0:10:28The scam begins when one or two cars move in front of the victim.

0:10:29 > 0:10:34The first car brakes, causing the second car to stop suddenly,

0:10:34 > 0:10:37which in turn causes the innocent victim to crash into the back

0:10:37 > 0:10:39of the second car.

0:10:41 > 0:10:44Car one then drives away leaving the driver of car two

0:10:44 > 0:10:47to cash in on a hefty insurance pay-out

0:10:47 > 0:10:50at the expense of the victim's insurance company.

0:10:51 > 0:10:54Induced accidents like these are a serious problem,

0:10:54 > 0:10:58but the industry and the police are working together to stamp it out.

0:10:59 > 0:11:03Direct Line Group were recently involved in bringing down an

0:11:03 > 0:11:07operation worth over £1 million, although, initially, they had no

0:11:07 > 0:11:10idea of the scale of what they were dealing with.

0:11:10 > 0:11:13On face value, everything appeared to be genuine,

0:11:13 > 0:11:15the boxes were ticked, so to speak.

0:11:15 > 0:11:18Everything appeared as if it was an authentic claim.

0:11:18 > 0:11:20And as with due processes,

0:11:20 > 0:11:23the claims were settled in a timely fashion.

0:11:23 > 0:11:28It wasn't until we were approached by the Metropolitan Police that our

0:11:28 > 0:11:31attention was drawn to the fact that these claims that had been settled

0:11:31 > 0:11:33were likely to be actually fraudulent.

0:11:34 > 0:11:38The police provided Direct Line with the details of those suspected

0:11:38 > 0:11:39to be involved.

0:11:39 > 0:11:44Armed with those details, we were able to check our records and we

0:11:44 > 0:11:49were then able to identify, yes, indeed, we had policies and claims

0:11:49 > 0:11:52with those individuals concerned.

0:11:54 > 0:11:58We then provided the claims details together with statements and

0:11:58 > 0:12:04exhibits to the Metropolitan Police to aid them in their investigations.

0:12:04 > 0:12:08It soon transpired just how serious this fraud ring was.

0:12:08 > 0:12:13The actions of the fraudsters were extremely dangerous.

0:12:13 > 0:12:17These individuals were totally reckless in their actions.

0:12:17 > 0:12:21They were staging accidents on main arterial routes

0:12:21 > 0:12:24in and around London, with total disregard to those occupants and

0:12:24 > 0:12:29vehicles that they were inducing to crash, which could involve young

0:12:29 > 0:12:31children, vulnerable persons,

0:12:31 > 0:12:33at significant risk of personal harm.

0:12:37 > 0:12:41Thankfully, nobody had been seriously injured in any of the

0:12:41 > 0:12:44induced collisions, which was remarkable considering

0:12:44 > 0:12:46the magnitude of this dangerous operation.

0:12:47 > 0:12:51The overall financial benefit to those involved was in the region

0:12:51 > 0:12:57of £1.1 million, which spanned over 300 cash for crash collisions.

0:12:57 > 0:13:01Direct Line Group was fortunate, in a way,

0:13:01 > 0:13:04that we had four claims exposed to this group,

0:13:04 > 0:13:10but, that said, we still paid £57,000 in insurance claims.

0:13:11 > 0:13:14With almost 300 induced collisions,

0:13:14 > 0:13:17this was crash for cash on an industrial scale.

0:13:24 > 0:13:25Through their investigations,

0:13:25 > 0:13:29the police had identified the man who was behind the entire fraud.

0:13:30 > 0:13:32The ringleader in this case is Mr Jamil.

0:13:32 > 0:13:38Mr Jamil clearly had influence over those involved, as well as

0:13:38 > 0:13:42associations to a claims management company that he was running.

0:13:42 > 0:13:47Access to that claims management company would obviously give

0:13:47 > 0:13:54Mr Jamil very detailed inside knowledge of an insurance claims process.

0:13:54 > 0:13:58And it's with that knowledge that he was unable to subvert some of the

0:13:58 > 0:14:01processes and secure successful claims.

0:14:03 > 0:14:07By now, the police had identified exactly how the gang were causing

0:14:07 > 0:14:11the crashes and how they were fraudulently obtaining money from them.

0:14:14 > 0:14:18The staged accidents were formed predominately with three vehicles.

0:14:18 > 0:14:23The first vehicle was, for all intents and purposes, a decoy vehicle.

0:14:23 > 0:14:28That would then induce the second vehicle to brake heavily.

0:14:28 > 0:14:34That in turn would then cause the innocent third vehicle to also brake

0:14:34 > 0:14:38and collide with the rear of the second vehicle...

0:14:39 > 0:14:43..with total disregard to the personal safety of the occupants

0:14:43 > 0:14:46of those innocent people in the third vehicle.

0:14:46 > 0:14:50Vehicle one would drive off leaving the two vehicles at the scene.

0:14:51 > 0:14:54And it's these patterns that were becoming evident

0:14:54 > 0:14:56to the Metropolitan Police.

0:15:00 > 0:15:04In the circumstances of this organised crash,

0:15:04 > 0:15:09the offending vehicle, vehicle two, would normally have the driver,

0:15:09 > 0:15:15but more often than not, the insurer would then see third-party claimants

0:15:15 > 0:15:20coming in at a later date who will be seeking compensation in respect

0:15:20 > 0:15:23to injuries received following the impact.

0:15:25 > 0:15:28And this is a term we often refer to as phantom passengers.

0:15:28 > 0:15:30These are passengers that are claiming for injuries,

0:15:30 > 0:15:33having been in the vehicle at the time of the accident,

0:15:33 > 0:15:35when in fact they were not in the accident at all.

0:15:35 > 0:15:37So in addition to vehicle damage,

0:15:37 > 0:15:41the gang would profit by making personal injury claims against the

0:15:41 > 0:15:45victim's insurance for passengers that weren't even in the car.

0:15:46 > 0:15:51After several years thinking they had got away with it, the net

0:15:51 > 0:15:53was closing in on Jamil and his accomplices.

0:15:55 > 0:16:00The police were able to utilise the evidence that we had provided them

0:16:00 > 0:16:01in respect of our claims.

0:16:01 > 0:16:05That, together with evidence provided by other insurers,

0:16:05 > 0:16:11enabled the police to securely arrest 19 individuals who they

0:16:11 > 0:16:15believed were involved in the organised activities.

0:16:18 > 0:16:19When the case went to trial,

0:16:19 > 0:16:23numerous members of the gang were handed custodial sentences,

0:16:23 > 0:16:25but it was the ringleader, Mohammad Jamil,

0:16:25 > 0:16:30who the judge came down on the hardest with five years behind bars.

0:16:32 > 0:16:36Five years is not an insignificant sentence for which gives

0:16:36 > 0:16:41Mr Jamil time to step back and reflect on his actions and

0:16:41 > 0:16:44realistically think, "Was it all worth it?"

0:16:45 > 0:16:48For the police and the many insurance companies who had been

0:16:48 > 0:16:51targeted by Jamil, it was an excellent result.

0:16:51 > 0:16:55But most importantly, it had brought an end to the dangerous collisions

0:16:55 > 0:16:58that the gang were causing to innocent members of the public.

0:17:00 > 0:17:03These type of incidents have far-reaching consequences.

0:17:03 > 0:17:07We were lucky we can say that the injuries were somewhat minor.

0:17:07 > 0:17:12In my experience, I've actually dealt with situations such as these

0:17:12 > 0:17:15where a member of the public actually lost their life.

0:17:15 > 0:17:20So if I take this type of fraud exceptionally seriously,

0:17:20 > 0:17:25I will put all my resources into ensuring that one,

0:17:25 > 0:17:29it is identified at an early stage, two, that those who seek to

0:17:29 > 0:17:32defraud the industry are held to account.

0:17:32 > 0:17:36And thirdly, ensure that they receive the due punishments that they deserve.

0:17:42 > 0:17:46Now, if you're unfortunate enough to have an extensive period of sickness

0:17:46 > 0:17:49or a prolonged injury, that may keep you out of work,

0:17:49 > 0:17:53therefore, having a serious effect on your livelihood.

0:17:53 > 0:17:54In situations like that,

0:17:54 > 0:17:58an income protection policy can come to the rescue.

0:17:58 > 0:18:00But just like any other form of insurance,

0:18:00 > 0:18:04it is open to abuse by chancers and opportunists.

0:18:05 > 0:18:10I-COG is a company that specialises in validating insurance claims that

0:18:10 > 0:18:12have been highlighted as suspicious.

0:18:12 > 0:18:16They recently dealt with a case where an insurer suspected that one

0:18:16 > 0:18:20of their policyholders was claiming money that he wasn't entitled to.

0:18:20 > 0:18:24Income protection is essentially there for genuine customers to claim

0:18:24 > 0:18:28against should they unfortunately suffer any injury or illness that

0:18:28 > 0:18:30prevents them from working.

0:18:30 > 0:18:34And what the policy is there to do is to provide them that regular

0:18:34 > 0:18:38income during periods such as rehabilitation, hospital stays,

0:18:38 > 0:18:42or just the fact that they are permanently or temporarily disabled.

0:18:42 > 0:18:45For many, a policy like this can be a financial life-saver.

0:18:47 > 0:18:51However, with this type of insurance cover, there are clear conditions.

0:18:51 > 0:18:55One of the main exclusions for most income protection policies is any

0:18:55 > 0:18:59form of income. So as soon as an insurer suspects that there is

0:18:59 > 0:19:02undisclosed income being received, then, of course, any payments made

0:19:02 > 0:19:05against that policy would be null and void.

0:19:05 > 0:19:10And Tara's client suspected that was exactly the case with the claim they

0:19:10 > 0:19:12referred to her.

0:19:12 > 0:19:15This claimant was originally employed as a HGV driver.

0:19:15 > 0:19:18He advised that through the course of his employment, he injured his

0:19:18 > 0:19:22right shoulder and as a result of that, clearly wasn't able to carry

0:19:22 > 0:19:25out his normal employment and therefore was off work.

0:19:25 > 0:19:29Sounds plausible enough but there was a twist.

0:19:29 > 0:19:33This was referred to us because the claimant had just incorporated

0:19:33 > 0:19:37a business at Companies House in a completely different market.

0:19:37 > 0:19:42And, of course, that was in no way synonymous with the claim form he'd presented.

0:19:42 > 0:19:43Having taken on the case,

0:19:43 > 0:19:48the first task was to carry out a full investigation of the claimant.

0:19:48 > 0:19:50But it soon became apparent

0:19:50 > 0:19:53that they were dealing with a bit of an entrepreneur.

0:19:53 > 0:19:56We had a range of Companies House signatures which matched

0:19:56 > 0:19:59the claim form that the claimant had presented.

0:19:59 > 0:20:04We had social media profiles for the new business which was going through

0:20:04 > 0:20:07its infancy, so marketing and promoting that business

0:20:07 > 0:20:08was very strong.

0:20:08 > 0:20:11This all tied back to the claimant.

0:20:11 > 0:20:15This new business venture definitely didn't tie in with someone

0:20:15 > 0:20:17completely unable to work.

0:20:17 > 0:20:21And it was the claimant's online activities that had provided a lot

0:20:21 > 0:20:23of the evidence.

0:20:23 > 0:20:26When someone says they can't do something and, of course, on

0:20:26 > 0:20:28social media they're saying something else,

0:20:28 > 0:20:32naturally that's going to call into question the authenticity of the claim.

0:20:32 > 0:20:35With evidence of a new company incepted in the claimant's name and

0:20:35 > 0:20:40clear activity to promote it, it was time to see first-hand exactly what

0:20:40 > 0:20:42he was up to on a daily basis.

0:20:42 > 0:20:47As soon as we profiled everything, we very quickly moved into

0:20:47 > 0:20:50a surveillance operation which was carried out for a couple of days on

0:20:50 > 0:20:54all of the premises that we'd identified and the subject himself.

0:20:56 > 0:21:00It wasn't long before the undercover operative hit the jackpot.

0:21:04 > 0:21:09So what we have here is very active left and right movements

0:21:09 > 0:21:13of the right arm, originating from the right shoulder

0:21:13 > 0:21:17which clearly we'd been advised was totally impaired.

0:21:19 > 0:21:21Bending, reaching up.

0:21:21 > 0:21:26This isn't just a one-off movement either, this is continuous over ten

0:21:26 > 0:21:29minutes, very free movement in all directions.

0:21:29 > 0:21:32The reaching with both arms,

0:21:32 > 0:21:35by sponging the windows and the shutters down.

0:21:36 > 0:21:41At no time even showing any ounce of pain or impingement

0:21:41 > 0:21:44from the shoulder at all.

0:21:44 > 0:21:47In addition to it being crystal clear what he was doing,

0:21:47 > 0:21:51there was also no confusion as to why he was doing it.

0:21:52 > 0:21:54What we actually already knew at this stage

0:21:54 > 0:21:58is this commercial premises was part of his new business start-up.

0:21:58 > 0:22:02So the love and care that he's paying attention to the property by

0:22:02 > 0:22:08cleaning it in such detail, before the shop even opens to the public,

0:22:08 > 0:22:13you know, he's showing a lot of pride in his new business.

0:22:13 > 0:22:18And now we can see him here actually stocking the shelves for the new

0:22:18 > 0:22:19business within the premises.

0:22:21 > 0:22:26As evidential footage goes, it was pretty much as conclusive as it gets.

0:22:26 > 0:22:30I'll be honest, when I first saw the footage, I was highly entertained.

0:22:30 > 0:22:33Because not only had the intelligence that we discovered

0:22:33 > 0:22:40been proven to be correct, but the movements were probably freer than

0:22:40 > 0:22:44myself in cleaning the outside of the premises, bending,

0:22:44 > 0:22:47stretching, wash on, wash off.

0:22:52 > 0:22:54It was... It was very entertaining.

0:22:56 > 0:22:58But as amusing as it was to watch,

0:22:58 > 0:23:02the underlying impact of the footage was very serious indeed.

0:23:03 > 0:23:07What we have to remember here is whilst this is going on,

0:23:07 > 0:23:12this individual is still advising his insurers that not only is he

0:23:12 > 0:23:17so injured that he cannot work, but he's not receiving any other income.

0:23:17 > 0:23:22And yet here we can see him sitting next to the till

0:23:22 > 0:23:25and a merchant payment machine which is actually registered in his name

0:23:25 > 0:23:27for the new business.

0:23:27 > 0:23:31Now, remember this is still a man who's saying that he has no other

0:23:31 > 0:23:34form of income. He's the sole shareholder,

0:23:34 > 0:23:37the sole director of the business.

0:23:37 > 0:23:41But he's still adamant that he is unable to work due to injury.

0:23:41 > 0:23:47And he's quite happy to continue his charade of defrauding the insurer.

0:23:47 > 0:23:49So, whichever angle you looked at it,

0:23:49 > 0:23:55there was absolutely no way that this claimant could deny any of this

0:23:55 > 0:23:58footage, that it wasn't him, that didn't relate to him and that

0:23:58 > 0:24:00he hadn't committed fraud.

0:24:02 > 0:24:05The claimant had been well and truly caught out.

0:24:05 > 0:24:08His insurance company's suspicions have been confirmed and they now had

0:24:08 > 0:24:10the proof they needed.

0:24:10 > 0:24:14It was immediately referred back to insurers.

0:24:14 > 0:24:18The payments were immediately stopped and the whole policy was voided.

0:24:19 > 0:24:23But the claimant wasn't going to go down without trying to worm his way

0:24:23 > 0:24:24out of it.

0:24:24 > 0:24:27The claimant's immediate reaction when the evidence was

0:24:27 > 0:24:32presented to him was to tell a lie and to say that he was actually

0:24:32 > 0:24:36helping a friend out in the premises on that particular day

0:24:36 > 0:24:38and there were no ties to him.

0:24:38 > 0:24:42Well, of course, clearly we'd a complete bulletproof case that

0:24:42 > 0:24:44that was not in fact true.

0:24:44 > 0:24:48And the claimant eventually did acquiesce and accepted the position.

0:24:50 > 0:24:55By this stage, the claimant had been paid £28,000 from his income

0:24:55 > 0:24:56protection policy.

0:24:56 > 0:24:59But if he thought he was able to keep it,

0:24:59 > 0:25:01he had another think coming.

0:25:01 > 0:25:03It was then important to do the right thing.

0:25:03 > 0:25:08So a law firm that we work closely with were then instructed to recover,

0:25:08 > 0:25:11through the civil process, all of the funds that he had received and

0:25:11 > 0:25:15he has now paid back every penny that he was illegally paid by the insurer.

0:25:15 > 0:25:17It's a cautionary tale.

0:25:17 > 0:25:22The claimant had started out with a legitimate injury and a legitimate claim.

0:25:22 > 0:25:26But thanks to his greed and dishonesty, he now had nothing.

0:25:33 > 0:25:38Surveillance is being used more and more to identify insurance fraudsters.

0:25:38 > 0:25:41But who are the people who capture the footage that's so often the

0:25:41 > 0:25:45difference between missing or identifying a fraudulent claim?

0:25:45 > 0:25:46We decided to find out.

0:25:48 > 0:25:51As you can probably imagine, following and secretly filming

0:25:51 > 0:25:56someone without being detected for hours on end is anything but easy.

0:25:56 > 0:25:58But what does it take to do the job?

0:26:16 > 0:26:21For those who think spending up to 14 hours at a time simply watching

0:26:21 > 0:26:23and waiting is a cushy number, think again.

0:27:02 > 0:27:04In the fight against insurance fraud,

0:27:04 > 0:27:07undercover operatives are here to stay.

0:27:07 > 0:27:10And they're no longer reserved for just the biggest cases.

0:27:33 > 0:27:39Still to come - a ham-fisted attempt to cash in with a bogus claim.

0:27:39 > 0:27:44It transpired that the claimant was in fact a professional boxer.

0:27:44 > 0:27:47And only six weeks after the date of this accident,

0:27:47 > 0:27:50he had been involved in a bout which had featured on YouTube.

0:27:57 > 0:28:01In their effort to combat fraud, insurers are carrying out an

0:28:01 > 0:28:04increasing amount of detective work to separate the genuine claims

0:28:04 > 0:28:07from the bogus ones.

0:28:07 > 0:28:10But sometimes attempts at fraud are so sloppy

0:28:10 > 0:28:13that it's all too easy for insurers to catch them out.

0:28:19 > 0:28:24Sadly, in this day and age, theft is an all too common occurrence and it

0:28:24 > 0:28:27only takes a split-second to become a victim.

0:28:27 > 0:28:31Whilst it can't take away the unpleasantness of what happened,

0:28:31 > 0:28:35an insurance policy can replace our possessions like for like.

0:28:35 > 0:28:40Insurers RSA recently dealt with a case from a customer in her hour of need.

0:28:42 > 0:28:46Unfortunately, Ms Chadwick had been travelling on a train...

0:28:48 > 0:28:54..and somebody had taken her handbag from the overhead luggage compartment.

0:28:54 > 0:28:57And she had lost the contents of the handbag,

0:28:57 > 0:29:02which included some electrical goods and the total value of which was

0:29:02 > 0:29:03around £1,500.

0:29:05 > 0:29:08So a simple and straightforward claim,

0:29:08 > 0:29:11which RSA promptly began to process.

0:29:11 > 0:29:14However, some routine checks about the address linked to the policy

0:29:14 > 0:29:16instantly raised a few questions.

0:29:18 > 0:29:22We checked to see whether there had been any previous claims and we

0:29:22 > 0:29:25couldn't find any previous claims against Ms Chadwick,

0:29:25 > 0:29:29but we did find there was a Mr Penhill who had made some

0:29:29 > 0:29:32previous claims from the same address.

0:29:32 > 0:29:35But Ms Chadwick told us that this was in fact her landlord

0:29:35 > 0:29:39and therefore it didn't raise any particular suspicion.

0:29:40 > 0:29:45We also asked Ms Chadwick to produce, if she could,

0:29:45 > 0:29:48any receipts or anything else, photographs,

0:29:48 > 0:29:53to validate the ownership of the items that she said she'd lost.

0:29:53 > 0:29:55And this she did.

0:29:56 > 0:30:00So far, so good. Everything appeared to be above board and with

0:30:00 > 0:30:03photographs to back up the items stolen from the train,

0:30:03 > 0:30:06it was full steam ahead with the claim.

0:30:09 > 0:30:10Or was it?

0:30:11 > 0:30:15At that point, it seemed like a genuine claim and in normal

0:30:15 > 0:30:19circumstances, we would've validated the items that had been lost

0:30:19 > 0:30:22and proceeded to settlement.

0:30:22 > 0:30:27However, it soon transpired that these weren't normal circumstances.

0:30:27 > 0:30:33Most people are probably aware that buried within the electronics,

0:30:33 > 0:30:35as it were, of a photograph,

0:30:35 > 0:30:41is data that will tell you when and where the photograph was taken.

0:30:41 > 0:30:45Such digital information is called metadata.

0:30:45 > 0:30:50In examining the photographs that had been sent to us,

0:30:50 > 0:30:53we found that the metadata in the photographs,

0:30:53 > 0:30:59embedded in the photographs actually told us that the photographs

0:30:59 > 0:31:04post-dated the loss, so that clearly aroused our suspicion.

0:31:04 > 0:31:07And it's hardly surprising it did.

0:31:07 > 0:31:10After all, how was it possible to take photos of items

0:31:10 > 0:31:13that had been stolen after they'd been stolen?

0:31:15 > 0:31:19But if this wasn't enough of a smoking gun, RSA soon uncovered even

0:31:19 > 0:31:24more evidence that suggested this was a fraudulent claim.

0:31:24 > 0:31:29We co-operate with other insurers to help us combat fraud and another

0:31:29 > 0:31:33insurer informed us of an interesting fact

0:31:33 > 0:31:35in relation to Mr Penhill.

0:31:35 > 0:31:42They had dealt with a previous claim by him and amongst the items lost

0:31:42 > 0:31:47was an item of jewellery, which surprise, surprise was identical to

0:31:47 > 0:31:51an item that Miss Chadwick had said she had lost.

0:31:51 > 0:31:57And the two items were purchased on the same day from the same store.

0:31:57 > 0:31:59What a coincidence.

0:32:00 > 0:32:03A bizarre coincidence indeed.

0:32:03 > 0:32:06Of course, when we then checked with the store itself,

0:32:06 > 0:32:10they told us that the receipts were in fact fraudulent

0:32:10 > 0:32:13and didn't come from them.

0:32:13 > 0:32:16So first, we had photos of allegedly stolen items miraculously

0:32:16 > 0:32:19taken after they'd been stolen.

0:32:19 > 0:32:23But now RSA had uncovered a previous claim by Chadwick's landlord for

0:32:23 > 0:32:29identical items purchased in the same store on the same day and both

0:32:29 > 0:32:33Chadwick and Penhill's claims were backed up with nearly identical

0:32:33 > 0:32:34fraudulent receipts.

0:32:34 > 0:32:37And if the claim hadn't been derailed already, well,

0:32:37 > 0:32:40the evidence just kept on coming.

0:32:40 > 0:32:44We also found other receipts from a shop which actually closed down

0:32:44 > 0:32:49three years ago and these receipts post-dated that, so, again,

0:32:49 > 0:32:52these were not genuine. By this time, of course,

0:32:52 > 0:32:54we'd determined we weren't going to pay this claim.

0:32:54 > 0:32:56It was fraudulent.

0:32:56 > 0:33:03We informed them of this fact and we reported both of them to IFED for

0:33:03 > 0:33:07them to consider a criminal prosecution in this case.

0:33:07 > 0:33:11IFED is the Insurance Fraud Enforcement Department.

0:33:11 > 0:33:16Formed in 2012, its dedicated police unit's sole purpose is to tackle

0:33:16 > 0:33:21insurance fraud and they were only too happy to take the case on.

0:33:21 > 0:33:25IFED investigated the case thoroughly, and at the end of their

0:33:25 > 0:33:28investigation, they charged both with fraud.

0:33:29 > 0:33:32They appeared at court, where they both pleaded guilty.

0:33:32 > 0:33:36Penhill was sentenced to six months imprisonment,

0:33:36 > 0:33:38suspended for 18 months.

0:33:38 > 0:33:42And Chadwick was given a 12 month community order,

0:33:42 > 0:33:45with a supervision order.

0:33:45 > 0:33:49Justice had been served after what can only be described

0:33:49 > 0:33:52as a poorly-planned and executed attempt at fraud.

0:33:52 > 0:33:56Yet, incredibly, it appears that at least one of the fraudsters saw

0:33:56 > 0:33:57themselves as a victim.

0:33:59 > 0:34:04As a bit of a footnote to this case, Miss Chadwick told us several times

0:34:04 > 0:34:08during our investigation that, you know,

0:34:08 > 0:34:14she was trying to give answers to our questions and accusing us

0:34:14 > 0:34:21quite ironically of using underhand tactics to catch her.

0:34:21 > 0:34:25I'd be quite happy to leave it to the members of the public to

0:34:25 > 0:34:29determine who was using underhand tactics in this particular case.

0:34:35 > 0:34:40For many of us, social media has become part of our everyday lives.

0:34:40 > 0:34:44It is a brilliant and easy way of keeping in touch with friends and

0:34:44 > 0:34:46family and sharing what you've been up to.

0:34:46 > 0:34:49However, when it comes to identifying fraudulent or grossly

0:34:49 > 0:34:55exaggerated insurance claims, social media can also have a huge part to play.

0:35:00 > 0:35:03Someone who's well aware of the importance of evidence from the web

0:35:03 > 0:35:05is Catherine Burt.

0:35:05 > 0:35:09She's Head of Counter Fraud at law firm DAC Beachcroft,

0:35:09 > 0:35:13who recently dealt with a case where social media packed quite a punch.

0:35:15 > 0:35:18The claim that we received was from the driver of a car,

0:35:18 > 0:35:20who said he'd been involved in a road traffic accident.

0:35:21 > 0:35:25On the day in question, the chap had been driving along the road.

0:35:25 > 0:35:28He'd come to a set of traffic lights and there was a car in front of him

0:35:28 > 0:35:30stationary, at the traffic lights, which were on red.

0:35:32 > 0:35:35He said that he'd stayed back behind that car,

0:35:35 > 0:35:39a couple of car lengths away and was just sitting at the lights when the

0:35:39 > 0:35:42car in front suddenly started to reverse back.

0:35:42 > 0:35:47Indeed, a frightening situation to be in and one where there's only so

0:35:47 > 0:35:48much you can do to stop it.

0:35:49 > 0:35:53His version of events was that he tried to stop the car by pipping

0:35:53 > 0:35:54his horn and shouting,

0:35:54 > 0:35:58but the car picked up speed and reversed quite quickly into his car.

0:36:04 > 0:36:07He said he sustained injuries to his neck and back.

0:36:07 > 0:36:10He was basically claiming whiplash injuries.

0:36:10 > 0:36:12But, as Catherine points out,

0:36:12 > 0:36:16just because you've been in a minor coming together between two vehicles

0:36:16 > 0:36:18doesn't automatically mean you'll suffer whiplash.

0:36:20 > 0:36:24We found that whiplash injuries are very common in road traffic accidents,

0:36:24 > 0:36:28but there is a specific amount of force required and if the force is

0:36:28 > 0:36:31very minimal, it's unlikely that there would be any injury at all.

0:36:32 > 0:36:35Nevertheless, the claimant was saying he'd been injured in the

0:36:35 > 0:36:37collision and was seeking compensation.

0:36:39 > 0:36:42He would've been expecting general damages for his injury of

0:36:42 > 0:36:44approximately £2,000.

0:36:44 > 0:36:48But when DAC spoke to their policyholder, her account was

0:36:48 > 0:36:51significantly less dramatic than that of the man who was

0:36:51 > 0:36:52claiming to have been injured.

0:36:54 > 0:36:59The first suspicious point was the difference in events between the

0:36:59 > 0:37:00claimant and the defendant.

0:37:02 > 0:37:05She had been bringing her children home from nursery and was stopped at

0:37:05 > 0:37:09the traffic lights. One of the children started to cry and she was

0:37:09 > 0:37:12distracted and at that point she felt a small impact.

0:37:17 > 0:37:20The other driver, the claimant, got out of his vehicle,

0:37:20 > 0:37:24was quite aggressive and was claiming it had been a substantial

0:37:24 > 0:37:26impact, which she didn't agree with at all.

0:37:26 > 0:37:30Differing versions of events from the drivers involved in a collision

0:37:30 > 0:37:32is neither new, nor surprising.

0:37:32 > 0:37:37However, it was the woman who very quickly appeared to be the most reliable.

0:37:37 > 0:37:42This was made more suspicious when we realised the damage to the

0:37:42 > 0:37:46claimant's car had only cost £61 to repair.

0:37:46 > 0:37:50As I'm sure anybody will realise, whenever you have your car repaired,

0:37:50 > 0:37:51it's generally expensive.

0:37:51 > 0:37:54So the parts had only cost £30.

0:37:54 > 0:37:56The labour had only cost just over £30.

0:37:56 > 0:38:01So it was obvious from that, that the impact hadn't been anywhere near

0:38:01 > 0:38:02what the claimant said.

0:38:03 > 0:38:08And the man's credibility was soon cast into even more doubt.

0:38:08 > 0:38:11The claimant had said that he'd never been involved in any other

0:38:11 > 0:38:14road traffic accidents and he reported that to his medical expert.

0:38:14 > 0:38:18Our routine checks showed that he had in fact been involved in quite a

0:38:18 > 0:38:22high number of previous road traffic accidents and he had made claims as

0:38:22 > 0:38:25a result of those, so it was difficult to see how he could've

0:38:25 > 0:38:27forgotten about them.

0:38:27 > 0:38:30So far, we have an allegedly serious injury,

0:38:30 > 0:38:34despite a minuscule amount of damage to his car and a selective memory

0:38:34 > 0:38:38when it came to recalling previous accidents and claims.

0:38:38 > 0:38:41But the dubious points of this case didn't end there.

0:38:42 > 0:38:48During the course of the claim, we saw many inconsistencies in various documents.

0:38:48 > 0:38:52Two medical reports were prepared and the claimant wasn't

0:38:52 > 0:38:55consistent in what he told the medical experts.

0:38:55 > 0:39:01On one occasion, we were told that the injuries would last for three

0:39:01 > 0:39:04months and he confirmed that they had resolved in three months.

0:39:04 > 0:39:07On one occasion, he told the medical expert that he was still suffering

0:39:07 > 0:39:10symptoms after eight months.

0:39:10 > 0:39:12He also served a signed witness statement,

0:39:12 > 0:39:14which again contained inconsistencies.

0:39:14 > 0:39:18For example, on one occasion he said his vehicle had been pushed back two

0:39:18 > 0:39:21car lengths by the impact of the claim.

0:39:21 > 0:39:25On another, he said at the end of the accident the tow bar from the

0:39:25 > 0:39:28vehicle in front was still attached to his car.

0:39:28 > 0:39:29So that clearly couldn't be true.

0:39:30 > 0:39:35With so many inconsistencies, the claim was far from rock solid.

0:39:35 > 0:39:40However, the next revelation really would have the claimant on the ropes.

0:39:41 > 0:39:45It transpired that the claimant was in fact a professional boxer.

0:39:46 > 0:39:49And only six weeks after the date of this accident,

0:39:49 > 0:39:53he'd been involved in a bout which had featured on YouTube.

0:39:55 > 0:40:00The footage quite clearly shows that he is perfectly able to move around.

0:40:00 > 0:40:03He'd managed to survive for eight rounds and probably given quite

0:40:03 > 0:40:05a good account of himself until, in the eighth round,

0:40:05 > 0:40:06he was knocked out.

0:40:08 > 0:40:12Unfortunately for the claimant, everything that the insurer needed

0:40:12 > 0:40:15to show that his claim had been grossly exaggerated was out there

0:40:15 > 0:40:18for the whole world to see.

0:40:18 > 0:40:21It was very surprising to find such a contradictory piece of evidence

0:40:21 > 0:40:24quite freely available on the internet.

0:40:24 > 0:40:27It does seem to be the case, however, that people don't equate

0:40:27 > 0:40:29the internet with something that will actually

0:40:29 > 0:40:33come back to haunt them and be used as evidence against them.

0:40:34 > 0:40:37Despite the video footage completely flooring his claim,

0:40:37 > 0:40:40the man was determined to see it through.

0:40:40 > 0:40:42During the course of the claim,

0:40:42 > 0:40:45the claimant instructed three sets of solicitors.

0:40:45 > 0:40:49The first two sets of solicitors withdrew from the claim

0:40:49 > 0:40:51once we'd put our evidence to them.

0:40:51 > 0:40:54But the third set of solicitors were prepared to take

0:40:54 > 0:40:58the claim on, issue proceedings and bring it to trial.

0:40:58 > 0:41:01This guy was either extremely stubborn,

0:41:01 > 0:41:04or as the footage they discovered suggested,

0:41:04 > 0:41:07simply didn't know when he was beaten.

0:41:07 > 0:41:09Rather surprisingly the case did go to court.

0:41:09 > 0:41:13We disclosed the footage of the YouTube video and the claimant's

0:41:13 > 0:41:15solicitors still proceeded.

0:41:15 > 0:41:18However, when it came to the day of the trial,

0:41:18 > 0:41:23the claimant didn't attend court and so the judge was prepared to dismiss

0:41:23 > 0:41:27the claim and made a finding of fundamental dishonesty.

0:41:27 > 0:41:31This effectively means the judge didn't believe any part of the man's claim.

0:41:31 > 0:41:35But if he thought by not turning up he'd escape any repercussions

0:41:35 > 0:41:41for his dishonest actions, then he was in for a very nasty surprise indeed.

0:41:41 > 0:41:44When the court makes a finding of fundamental dishonesty,

0:41:44 > 0:41:48that means that we then have the ability to get a costs order

0:41:48 > 0:41:51and enforce it against them, so that they actually have to pay the money

0:41:51 > 0:41:53back and they feel it in their pocket.

0:41:55 > 0:41:57And feel it he did.

0:41:57 > 0:41:59The original claim made by the claimant would probably have got him

0:41:59 > 0:42:03something just over £2,000.

0:42:03 > 0:42:07To get that amount of money, he clearly risked quite a large penalty

0:42:07 > 0:42:11and he's now ended up with an order against him for over £11,000,

0:42:11 > 0:42:16being the costs that the insurers incurred in defeating the claim.

0:42:16 > 0:42:21So, this boxing bully's tactics had backfired and he'd been given

0:42:21 > 0:42:22a taste of his own medicine.

0:42:22 > 0:42:27Only he'd been hit where it really hurts - in the pocket.

0:42:27 > 0:42:30This was a case which should never have been pursued.

0:42:30 > 0:42:34All of the time that is spent on investigating and

0:42:34 > 0:42:38repudiating fraudulent claims could actually be spent by insurance

0:42:38 > 0:42:42companies checking on the original claims and making sure they

0:42:42 > 0:42:43get paid properly and quickly.

0:42:43 > 0:42:47So it would be much better if we could eradicate those claims.

0:42:54 > 0:42:57Insurance fraud in this country costs all of us money,

0:42:57 > 0:43:00but the days of no questions asked pay-outs are numbered.

0:43:00 > 0:43:04Insurers are using ever more sophisticated technology

0:43:04 > 0:43:09to identify, track and prosecute fraudsters and courts are using new

0:43:09 > 0:43:12powers to put these criminals behind bars.