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00:06Insurance fraud has reached epidemic levels in the UK.
00:09It's costing us more than £1.3 billion every year.
00:13That's almost £3.6 million every day.
00:17Deliberate crashes, bogus personal injuries, even phantom pets.
00:23The fraudsters are risking more and more to make a quick killing.
00:27And every year, it's adding around £50 to your insurance bill.
00:31But insurers are fighting back, exposing just under 15 fake claims every hour.
00:37Armed with the latest fraud-busting technology.
00:40It's a subject out of the vehicle.
00:42Including covert surveillance systems, sophisticated data analysis techniques
00:47and specially trained fraud investigators.
00:50Oh, they're catching these chances red-handed.
00:54Instead of getting away with it, even more of these fraudsters are getting caught out.
01:00This is Rogue Claimers.
01:08Today, a heartless fraudster tries to profit from tragedies,
01:11including the Grenfell Tower fire, to make false insurance claims.
01:15One of the most devious insurance fraudsters that I have come across
01:19in my 20 years of working in insurance fraud.
01:22She presented claims close to £200,000.
01:26Pure greed. It's as simple as that.
01:29An adrenaline junkie showing off on social media
01:32forgets her adventure antics can be seen by all,
01:35including those investigating her injury claim.
01:39It didn't stop.
01:41It was one high-energy sport after the other.
01:45And it's three for two at a supermarket
01:48when a trio of scammers try to cash in.
01:51And we can see a trolley positioned
01:53and that's being put in place in order to disguise the fact
01:56that one of the ladies is putting some orange cartons onto the floor.
02:09The insurance world's hardened investigators have seen it all,
02:13but the next story shocked even them.
02:17A woman claiming to be present at three tragic events of summer 2017
02:22lodged fraudulent insurance claims with three insurers.
02:27Those who had dealings with her described her as a real piece of work.
02:32One of the most devious insurance fraudsters
02:35that I have come across in my 20 years of working in insurance fraud.
02:39She presented claims close to £200,000.
02:42Pure greed. It's as simple as that.
02:45This claimant was going to emerge as a notorious immoral scammer.
02:52Towards the end of 2016, the insurer, legal and general,
02:56made a discovery that would turn out to be just the beginning
02:59of this woman's fraudulent claims.
03:02One of our investigators was talking to a customer
03:05about how they had run out of fuel,
03:09parked the car up on the side of the motorway,
03:11bought to the nearest petrol station.
03:14The vehicle had been broken into,
03:16a bag containing valuable items had been taken.
03:20Theft from a vehicle is usually remote,
03:22at the side of a motorway where a vehicle is broken down.
03:26Not a very common scenario.
03:28Some weeks later, another claim was presented by a different customer
03:33that had very, very similar circumstances.
03:35One of our senior investigators overheard both the investigators
03:40talking about their cases, put two and two together,
03:43and thought, we need to look at these side by side
03:45and see if there's any similarities.
03:48The types of losses were very similar.
03:50Designer clothing, designer bags, purses, sunglasses.
03:55We even had one instance of a small England of gold being taken.
04:01The items didn't exist.
04:02The receipts were being manufactured, repeatedly used.
04:08What legal and general would later realise is,
04:11it had stumbled on the tip of the iceberg.
04:15Because at another insurance company, RSA,
04:19alarm bells over very similar sounding claims
04:21had been ringing since 2014.
04:24Initially, one claim was flagged to RSA for investigation
04:27as a result of the social network analysis tool.
04:30As soon as we opened up the network,
04:33we could see probably around about five or six other claims.
04:37And it was then that we saw that there was false information.
04:41A plethora of false details.
04:45Whoever was behind these had gone to great lengths to evade detection
04:49by creating multiple fake names, addresses,
04:52and even borrowing innocent people's identities to file multiple claims.
04:58All of the data was false.
05:00All of the data was different.
05:01But what was critical is an insurance fraudster once only one thing.
05:06And that is to be paid.
05:07And the only way to be paid is to provide us with your bank account information.
05:13There was more than one bank account used,
05:15but enough data matches were found to be able to link 17 claims
05:19back to a single suspect.
05:21It was at that point that we knew we were dealing with a prolific insurance fraudster.
05:28Insurer, legal and general, was also finding strong connections between claims.
05:33Some telephone numbers matched across different policies and claims.
05:38Fraud investigation can very much be like rabbit holes.
05:41You can end up down a rabbit hole and there's nothing there.
05:44And it's very important that investigators are alive to that
05:48and that, you know, they don't go chasing stuff that isn't there.
05:51But in this case, every time we said,
05:55let's have a look for that telephone number
05:57or let's have a look for that email address,
05:59we were finding yet another case.
06:02Once we completed our investigation,
06:04we had a network of 27 different policies.
06:09And seemingly one person having 27 different aliases.
06:15Determined to catch out the woman behind all these claims,
06:17legal and general came up with a plan.
06:20One of our investigators has an innate ability to recognise cases,
06:27circumstances, names, in some cases even telephone numbers or email addresses
06:33that he has seen previously.
06:35A human algorithm.
06:38What a massive asset for a case like this.
06:41Someone who could work his magic.
06:43It made sense for us to ensure that any further cases that were presented
06:48were investigated and dealt with by him.
06:53While legal and general was directing calls from the suspect onto its top investigator,
06:58RSA had passed on its evidence to a body called the Insurance Fraud Bureau,
07:03which holds information from across the industry.
07:07We have access to over 143 million records.
07:11We use the information that's contained in our databases
07:14to identify trends and patterns of activity
07:17and also follow up on leads we receive from insurers.
07:23Perfectly placed then to analyse the information received from RSA
07:27regarding the prolific suspect.
07:29It was discovered that the originator of this web of deceit
07:33was a woman from Scotland.
07:36We identified additional claims with other insurers
07:40and new identities and new aliases that she was using.
07:44She was arrested and questioned, but she answered no comment to all interview questions
07:49and was released on bail pending further investigation.
07:53Despite being arrested and subsequently bailed,
07:56she continued her behaviour, continued to make claims.
08:01By now, it had come to light that insurer Aviva had also been targeted by the woman.
08:06So it joined legal in general and RSA in the big investigation.
08:12And a pattern of behaviour was emerging.
08:16Invariably, there was some element of distress.
08:18Be that we broke down, we had to walk to a petrol station,
08:22or somebody has fallen, she had fallen and injured herself.
08:25And during the confusion, a bag had been lost,
08:28or an item of jewellery had been lost.
08:30There was always an element of distress in the claim,
08:37in the circumstance that had happened,
08:39which naturally would lead you, as a person listening to that claim,
08:43to have sympathy for that individual.
08:47As the evidence mounted up, police went to re-arrest the woman in 2017.
08:53As a result of the information that we provided to the police,
08:57a number of additional addresses were identified,
08:59and at one of these, she was found hiding behind a locked door in a bedroom.
09:06She appeared to be trying to hide items in that room.
09:09A search was conducted,
09:11and material relating to a raft of fake claims was uncovered.
09:16But amongst this paperwork,
09:18officers found evidence of troubling and previously undiscovered claims.
09:24In claims made to RSA,
09:26the woman firstly maintained she was in Manchester on the 22nd of May 2017.
09:33Right in the middle of the Manchester bombing event at the Ariana Grande concert.
09:44Thousands of people were desperately trying to get out of a smoke-filled building,
09:48so it's not surprising that items were left in the panic.
09:55As the news of the tragic events of that night sank in around the country,
09:59this audacious fraudster saw it as an opportunity to put in a fake claim,
10:04and a substantial one.
10:06She lost a designer handbag, a designer pair of sunglasses,
10:11a few thousand pounds, and a large amount of jewellery.
10:15Even for a fraudster, this was an exceptionally low move.
10:19But she didn't stop there.
10:22A couple of weeks later, terrorists targeted London Bridge,
10:26leaving eight dead and many injured.
10:30Unbelievably, this opportunist was counting herself amongst those affected.
10:34She had the same designer handbag, the same sunglasses,
10:39the same jewellery, and a large amount of cash on her.
10:44Just 11 days later, a claim was made for the same list of items,
10:49but they'd been lost in a fire at Grenfell Tower.
10:57Making false claims that exploited tragic events was a real shock,
11:02that somebody could sink to that level,
11:06and to exploit the victims and the families of the victims of that tragedy
11:11in order to make a personal gain of a few, you know, a few hundred pounds,
11:16effectively, that was quite shocking.
11:21It revealed a monumental lack of empathy,
11:24but deeper investigations showed this wasn't a new tactic.
11:29If we track back a couple of years, she'd actually tried it before,
11:33and she'd done it to us previously, when, unfortunately,
11:37somebody had been in hospital in her family,
11:39and while she was at the hospital, somebody stole
11:42her very expensive designer handbag, her large amount of cash,
11:45and the large amount of jewellery that she also had in the same bag.
11:53No event, however heartbreaking, was off-limits to this woman's opportunistic greed.
11:59Finally, when it came to the trial, the full extent of her deceit was revealed.
12:03In total, she took out 70 fraudulent policies, she made 50 fraudulent insurance claims,
12:11with a total reserve of £179,000, and she was paid out, ultimately, £50,000 before she was caught.
12:22People that are prepared to commit fraud, with that level of determination,
12:29inevitably will be successful at some point.
12:32But they've got to be successful every time.
12:36We only need to catch them once.
12:38So, you may not get caught the first time, you may not get caught the third time,
12:42but you will eventually get caught, and there is a consequence to it.
12:47We often see large numbers of organised insurance fraud cases,
12:52and they can run into hundreds of claims.
12:54But they're usually, as a result of organised criminal gangs, making those claims.
12:59But in this instance, to find a single individual responsible for so many cases, it is unusual.
13:07The woman was found guilty of fraud by false representation and money laundering offences.
13:12She was sentenced to three years in prison.
13:24The fact that somebody would sink to those depths to exploit those events for their own personal gain,
13:30was truly shocking.
13:31This individual played on the heartstrings, and she notified all of her claims online,
13:36so she didn't even have to speak to anybody.
13:39She knew about our systems, she knew about our processes,
13:42and effectively she manipulated that for her own gain.
13:46And we are very pleased, as RSA, to see that she is now languishing in prison.
13:56Later, a cat owner grossly inflates a claim when she loses two of her moggies.
14:02Each cat had been sold for £1,850,
14:06which is probably about £1,000 more than we expected to have seen.
14:19Whether it's filming yourself for a social media post,
14:23or CCTV surveillance for shop owners,
14:27cameras are definitely part of our everyday lives.
14:33But given the sheer size and scale of all that data,
14:38you can't store it forever.
14:42So, if an insurance claim arrives after the footage is erased,
14:46a business can be left without the evidence needed to defend itself.
14:52Fraudsters definitely know how to take advantage of this.
14:55And without CCTV, they might even get away with it.
15:02The claim that came in was for injury and loss suffered as a result of a fall.
15:08It was a stumble, whilst she was in her local supermarket.
15:12The claimants in this matter alleged that she had stumbled over some orange cartons,
15:17which were on the floor.
15:18And she alleged that she had suffered injuries to her shoulder, to her calf, to her ankle and to her
15:24hip.
15:25Injuries like this could cost the company an arm and a leg.
15:29The claim when it came in was estimated at potentially £20,000.
15:33The circumstances described are certainly feasible,
15:36but as with every single claim that comes in,
15:39we will always undertake investigation with our customer to verify the facts that are presented.
15:46The first thing that seemed odd was that the letter had come in a year after the fall.
15:52So Aviva contacted the shop to find out what had happened.
15:57The supermarket was unaware of the incident at the time, as it wasn't reported.
16:04This seemed strange, as the woman claimed she had spoken with the manager after the fall
16:09and asked it to be logged in the accident book.
16:13So Aviva wanted to check in with the supermarket and see if there was other evidence.
16:19Our customer was able to provide us with some CCTV footage of the alleged incident.
16:27Which was fortuitous, since the claim had come in 12 months after the alleged slip and fall
16:32and the CCTV footage could easily have been erased.
16:37We were very surprised by what we saw on the CCTV footage.
16:42Aviva could see the moment the claimant collided with the cartons of orange juice.
16:47Here are the offending cartons.
16:49We saw the claimant do what can only be described as a small stumble across the orange cartons
16:56and certainly in no way fall to the floor.
16:59Definitely a little stub to the toe.
17:01But it didn't seem like a fall to have caused chronic hip pain and injury to her calf and shoulder.
17:07We were expecting to see quite a significant fall, fall to the ground over the orange cartons.
17:16But it's what happened a few minutes before that terrible fall that takes things to a whole new level.
17:24What we actually saw was the claimant in discussion and collusion with two other ladies.
17:31We can see the three ladies begin to congregate by the orange juice cartons.
17:36And then we can see a trolley positioned and that's being put in place in order to disguise the fact
17:41that one of the ladies is putting some orange cartons onto the floor.
17:46Now the trolley is being moved away.
17:48The claimant's co-conspirator takes a photo to show the dangerous trip hazard.
17:55Takes off.
17:57And leaves our fraudster to give her BAFTA award-winning performance.
18:01From the left of the screen, we'll see the claimant come across and stumble over the cartons.
18:09Not only was the fall staged, but she had willing accomplices to swindle the supermarket.
18:15The CCTV footage in this case was critical because it clearly evidenced that the claimant had been in collusion
18:23with two other ladies in order to stage this accident.
18:28Rather than it being in any way the fault of our customer.
18:33One couldn't get more proof than the CCTV footage that this was a fraudulent claim.
18:39With proof that the woman had planned a fall in order to squeeze 20 grand out of the supermarket,
18:45Aviva showed her solicitors its evidence.
18:48We were surprised that the claimant at this point continued with the claim.
18:52At trial, the judge found that the claimant was fundamentally dishonest and dismissed her claim and awarded Aviva its costs.
19:01But the story then got even juicier.
19:04Aviva was not content to let the matter rest there, so we prosecuted the claimant for contempt of court.
19:12It was closing time for this fraudster, who as a former law student was now going to face the biggest
19:18lesson of all.
19:20Trial at Crown Court.
19:24Given the premeditated nature of her actions, the judge was not lenient.
19:30The woman received a 21-month suspended jail sentence, was put under curfew and has to wear an electronic tag.
19:39To anyone who thinks it's acceptable to commit this kind of fraud, I would suggest that they should take heed
19:45of the sanctions that can be imposed,
19:47of the fact that custodial sentences can be imposed, and they shouldn't do so lightly.
20:01Most cat owners tend to have pet insurance in place to cover vets fees.
20:06Bills for illness and injury can clock up.
20:08And policies also provide cover should your animal die or go missing.
20:15Insurer Agria specialises in pets.
20:18And early one summer, it learnt of a cat which had not been seen since April the 1st.
20:23It's very unfortunate when we receive claims of this type.
20:27Now, it's partly what insurance is there for, but often as not, we have distraught owners on the phone.
20:32In this instance, possibly because there have been a passage of time since the 1st of April,
20:36the owner on the phone seems fairly matter-of-fact, all things considered.
20:42Hi, I'm just trying to download a claim form.
20:47I'm going to put one in for my cat who's been missing.
20:50She went missing on the 1st of April.
20:57I think it's been passed for 45 days now.
21:00Okay.
21:02Within our policy, we have a 45-day period when cats or dogs go missing,
21:07whereby the owner tries to find them, advertises for the return, perhaps offers a reward,
21:12talks with local veterinary practices and endeavours to try and find the cat.
21:16But after a period of time, when they've gone missing, they've gone missing.
21:19And we will refund the purchase price.
21:21So is it just saying, in fact, the purchase price is what you want to do?
21:25Yeah.
21:26Okay.
21:27Compared to dogs, we do get a relatively higher number of missing cats.
21:33By the very nature of cats, I think in law they're deemed free spirits.
21:37Most cats tend to wander, have their patch and investigate the local environment.
21:44The missing cat was one thing, but the fate of its feline friend brought a macabre twist to the story.
21:51At the same day, guess what happened?
21:55My other cat, when we came home, we found her dead in the garden.
22:01And my other cat was missing.
22:03We don't know if she was attacked and then the other ones just run off or if she was then
22:07taken.
22:08So we don't really know, but we haven't obviously had her returned or found her.
22:14It's slightly unusual that there was a dead cat and a missing cat on the same day.
22:18But in itself, that wouldn't really have set hairs running.
22:22Sorry to ask, because that must be really distressing in this circumstance.
22:25I know that you say that you found her dead, but was she taken to a vet for any burial
22:29or cremation?
22:29Or would the vet be able to sort of verify her?
22:31No, we buried her because she was obviously ruled out throughout the day.
22:35I don't know what time it had happened.
22:38And we didn't obviously take care of it until the next day.
22:41And she was already sort of obviously decomposing and it was quite gruesome.
22:45So I did take a photo of her.
22:50Obviously, you can see that she's obviously dead in the picture.
22:53But she wasn't taken to the vet of the burial because we buried her at home.
22:57Were they microchipped at all?
22:59They were both microchipped.
23:01Yeah, okay.
23:02So have you got anything from your breeder?
23:03Yes, I do.
23:05Oh, that's fantastic.
23:06In terms of the supporting documentation, to all intent and purpose, everything was there.
23:11We had a completed claim form.
23:12We had photographic evidence that the dead cat actually was dead.
23:17And we had a receipt from the breeder, you know, for the purchase price that was being claimed.
23:21And a covering letter just stating the facts as a policy holder had explained them to us.
23:29There was supporting paperwork, but was it all in order?
23:33In terms of the next step in the process, the assessor made a phone call to the breeder just to
23:38verify the documents that we had and the claim that was on the table.
23:42That phone call proved to be quite enlightening.
23:45I was wondering if you could help me.
23:46We've had a claim for a kitten that I believe was bought from you.
23:51I think they were sold in around August 2017.
23:56Unfortunately, one of them has passed away.
24:00And so we just wanted confirmation of the purchase price if you, I don't know if you've got that to
24:05hand there.
24:06I think it would have been around 800.
24:09800?
24:11Because it was on the bit insurance, yeah.
24:13Okay.
24:14The only reason we're asking is because we've got a typed up receipt saying the purchase price for both of
24:23them is £3,700 because she bought two kittens from you.
24:28How much?
24:29So £3,700 for the two of them.
24:32No.
24:32Okay, so now I'm in, yeah.
24:35That was gross.
24:37So we can see that it's a lot different as well from the market value.
24:44The purchase price of the cats was significantly more than the market price that we'd expect.
24:50In fact, in this instance, each cat had been sold for £1,850, which is probably about £1,000 more
24:58than we'd expected to have seen.
25:01And it emerged this wasn't the only oddity in this case.
25:05Sir, if you speak to her, I don't want to talk to that woman, I've talked to her before.
25:09I've actually replaced a kitten to her.
25:11Okay.
25:13Okay.
25:14That's about a year and a half ago.
25:16A year and a half ago.
25:17Okay.
25:19Okay.
25:20The breeder revealed that two kittens she'd sold to the claimant had died of a viral disease, and that she
25:25had replaced them with two new ones, free of charge.
25:29That would have replaced the kittens for her, free of charge. Why is she claiming on insurance?
25:33No problem.
25:34There's no way I've ever sold two kittens to that part of the stupid.
25:36No. Okay.
25:37No problem. That's fine. Thank you for confirming that as well.
25:39All right. No problem. Take care. Thank you. Bye.
25:42In instances of this type, where animals go missing and aren't found, or where they die, our policies provide for
25:51the purchase price of those animals.
25:53Obviously, in this instance, there was no purchase price.
25:56Agria provided the breeder with a copy of the receipt it had to check against her own.
26:03That's not my signature, A. And B, it's not my phone number on this.
26:07Okay.
26:08So the receipt that we were given is not one that you would have sent, basically?
26:11No.
26:12I'll make a note. It's not your signature.
26:13Not my phone number.
26:14Yeah. You think this has been copied the signature?
26:18Yeah, man. They're just trying to do something dodgy, yeah.
26:21Okay.
26:21I wouldn't like something like that.
26:22Oh, no, no. That's fine.
26:23Three and a half thousand pounds. You're having a laugh. My pets don't cost that.
26:28It was clear at this point that the claim wasn't all it purported to be.
26:32The breeder was not impressed with the claimant's actions.
26:35But she realised Agria may hold some useful information in-house that would help the investigation.
26:41You all have copies of my signature and documents here about four or five years ago.
26:45Do you have policies with us as well?
26:47I used to. I don't anymore.
26:48Okay.
26:48Because nothing goes wrong with my pets.
26:50Oh, okay.
26:51It's getting too expensive.
26:52Yeah.
26:52Well, touch wood.
26:54Yeah, fingers crossed.
26:56It actually annoys me that they're the same thing and then they try and forge my signature
27:02like that.
27:02So that's not your signature?
27:04No, you can see it's not.
27:05Oh, gosh.
27:06And that money.
27:07Mm-hmm.
27:08You can check my bank accounts. You can sign the text, man. I've never had that kind
27:12of money given to me by her.
27:14Okay.
27:14Ever.
27:15By anybody.
27:16Obviously.
27:18That'd be good, wouldn't it?
27:20Yeah.
27:21I haven't spoken to her since.
27:23Okay.
27:23The breeder went on and found the original documentation.
27:28It showed very clearly when the cats had been provided, why they've been provided and
27:34that they were provided free of charge in replacement for two cats that had got ill and
27:38sadly passed away.
27:41The claimant's tall tails had been exposed.
27:44And for Agria, the next step was quite straightforward.
27:47At this point, we declined the claim.
27:51Given the claimant had tried to claim a significant amount for cats that had actually been replaced,
27:57she was very lucky this case didn't go further.
27:59Perhaps she realised that.
28:01Occasionally when we reject claims and claims of this nature, and for some reason we haven't
28:06got it quite right, we usually have an irate policyholder on the phone call coming back,
28:12justifying the claim, adding more evidence, which is fine.
28:15We can only assess claims on the evidence that we have and the facts that we have.
28:19In this instance, we heard nothing from the policyholder.
28:23We didn't get a phone call.
28:24We didn't get a letter.
28:26We didn't get an email.
28:27She just disappeared.
28:33Still to come, trouble comes in threes for a very unlucky road user.
28:39We now have three accidents involving five car seats and the total amount of the claims
28:47presented to us were bordering £4,000.
29:01No parent wants to take chances with the safety of their kids, especially when you're ferrying
29:06them around in your motor.
29:08In fact, not only is a car seat legally required for anyone under 12 or less than 135 centimeters
29:16in height, experts recommend replacing the seat after any accident.
29:21Even if it looks sound, there can be structural weaknesses.
29:24And for those with lots of precious cargo in the back seat,
29:28replacing multiple ones can be pricey in the event of a collision.
29:32So, it's good to take out a motor insurance policy that covers the full cost of replacing it.
29:38Direct Line is one of several insurers that will have you covered.
29:41Should there be a car seat damaged during an accident, we will automatically replace it.
29:45It's just a duty of care that we consider that we hold towards our policyholders.
29:53It certainly came in handy when one of its customers had a bit of a prang.
30:00Our policyholder was driving on the main road and a third-party vehicle pulled out from a minor road and
30:05a collision took place.
30:08We received a claim for a baby car seat in the sum of £375.
30:13We requested proof of purchase and this was sent in, validated, seemed all perfectly normal and it was paid.
30:21Everything was above board.
30:23Direct Line was happy with the circumstances its policyholder had reported and with the receipt he'd sent in.
30:31That policy subsequently expired and a new policy was incepted by the same policyholder.
30:39It was comprehensive again, it was a motor policy.
30:42Two months into that new policy, the customer was back in contact with Direct Line again.
30:49Again, they were involved in an on-fault accident and presented two car seats to us on that occasion.
30:57Altogether, these two car seats totaled approximately £1,500.
31:03Again, on this occasion, there appeared to be no concerns in respect of the circumstance of the accident or the
31:08validity of the receipt for the car seats.
31:10So, the policyholder was paid.
31:15With the replacement seats paid for, the unlucky driver could get his kids safely back on the road.
31:22However...
31:22Lo and behold, another two months later, the policyholder had a further non-fault accident.
31:27And again, two further receipts were presented to us for payment in respect of baby car seats.
31:33The car seats this time totaled in excess of £1,300.
31:39The amount of misfortune this claimant was having had not gone unnoticed.
31:44So, accidents do happen.
31:47However, over a two-year period, we now have three accidents involving five car seats.
31:57And the total amount of the claims presented to us were bordering £4,000.
32:05Something seemed amiss, and then Direct Line got a call.
32:10We were contacted by another insurer for some information in respect of our policyholder.
32:17And it came to light that actually we were victims of insurance fraud, as were they, as were another insurer.
32:25They were going into big stores, buying car seats, quite expensive ones.
32:33So, taking photocopies of the receipts, invoices, and then returning the car seats, getting their money back,
32:39and then providing insurers with duplicate and photocopied invoices.
32:46A serial car seat scammer was at large, and he had been cashing in all over the place.
32:53Across the three insurers, they would have netted in the region of £12,000 over a two-year period.
33:01Our policyholder probably tested the water initially.
33:04He received £370 without a buyer leave, got braver the next time, claimed for a further two,
33:13ramped it up again the next time.
33:16This was a calculated, large-scale fraud, so the insurers referred the matter to the authorities.
33:22The police attended the policyholder's address.
33:25He admitted the fraud, and he was given a conditional caution.
33:29The condition of the caution was that he paid back the amount of money that we had paid out to
33:34him
33:34within a certain amount of time.
33:38The claimant was being given a second chance, but would he buckle down and make amends?
33:45The policyholder failed to pay the money back to us within the timeframe stipulated by the court.
33:52He was then ordered to appear at the magistrate's court,
33:56where he was charged with five counts of fraud by misrepresentation.
34:02And now at Crown Court, he would sit before a judge.
34:07The policyholder was sentenced to serve a three-month curfew at a designated address
34:14and to attend a rehabilitation course.
34:18The conviction in respect of the five counts of fraud by misrepresentation
34:22will be on his record for the rest of his life.
34:27Three car claims, three insurers swindled, three strikes, and he's out.
34:34This practice was obviously very methodical, well thought out, calculating.
34:39However, they obviously weren't aware that we share information between us all.
34:45Cases like this only serve to demonstrate the importance of cross-industry collaboration.
35:01We put all our exploits online to be seen and shared.
35:05Friends and family can enjoy keeping up with our news.
35:09But unrestricted access means our day-to-day activities can be scrutinised, which can be very useful.
35:17BLM assists insurers with contentious and challenging claims.
35:20The firm investigated the following case involving an adrenaline junkie who claimed she'd suffered debilitating injuries
35:28despite being able to snowboard, sail and scuba dive.
35:32This was a changing lanes incident.
35:35So the claimant was travelling in a taxi and the defendant moved across lanes
35:41and collided with the taxi vehicle that the claimant was in.
35:44The defendant admitted he was at fault for the incident, that he had negligently changed lanes without looking and caused
35:51the impact.
35:53It was only a minimal accident, so there wasn't much damage to either vehicle
35:58and no injury claims were presented at the time of the incident.
36:02This sounds like it may be the shortest and most straightforward case we'll see.
36:06So far, there's no case.
36:09But a claim will follow and it's not straightforward at all.
36:12This is a strange thing. The claim wasn't presented until three years following the incident.
36:18A lot had happened during this time.
36:21Newborn babies had started nursery school by the time the claimant had made her move.
36:25The claimant alleged she'd sustained neck and back injuries as a result of the incident
36:31and that it had taken her around 13 months to recover.
36:37The claimant had been to see a medical expert to back up her case, but BLM had some doubts.
36:43She only went to see the medical expert three years after the accident, at which time she'd recovered.
36:50So the medical expert was very reliant upon what the claimant essentially was telling him.
36:56She told the medical expert that she was in some significant pain for the first couple of months post the
37:04accident
37:04and that she actually needed assistance with lifting shopping bags, with housework, with other various bits and pieces.
37:15Whilst the evidence is valid, it always causes concerns that a claimant presents a claim so late in the day
37:22where there's no objective evidence to support the claim.
37:25And at that point, alarm bells start ringing with the insurance company.
37:31The case was referred to us to investigate because of those concerns.
37:37How do you investigate something that happened three years previously?
37:42The insurer needed some kind of time machine.
37:46One of the first things we did was take a look at social media.
37:51The internet is a sort of time machine.
37:54The digital age sees us publish our movements and activities for all to see, including investigators.
38:00We found evidence of the claimant attending a heavy metal concert on the actual evening of the incident.
38:11When she was allegedly in significant pain, we also found that she had been snowboarding.
38:19Not just the nursery slopes, she braved the black runs.
38:24Black runs are quite high-octane runs.
38:28And there was more.
38:30It didn't stop. It was one high-energy sport after the other.
38:36You name it, she did it.
38:37Pumping iron in the gym, horse riding and surfing.
38:43Actually, in the July following the accident, she learnt a whole new sport in scuba diving.
38:49It was brand new to her, according to her posts.
38:55For somebody in so much pain with her back and her shoulders to have such a heavy tank on her
39:01back and be able to scuba dive clearly isn't consistent with what she'd advised the medical expert.
39:08If it had been a genuine incident, we wouldn't have expected to see anything on social media, but actually the
39:13fact that the claimant was so active on social media painted a real picture that the claimant continued to enjoy
39:20her life very much, so absent of pain.
39:25And oblivious to the fact her love of adventure sports hadn't gone unnoticed.
39:31The claimant issued court proceedings for her compensation and we did exchange statements during the course of the proceedings, so
39:40she was aware that we'd discovered the social media, but despite that, she continued to proceed to trial.
39:47Given the risks, this thrill seeker seemed to be totally fearless.
39:52I think that she thought she could hoodwink the judge and in fact, while she was giving evidence on the
39:58witness box, she told the judge that she was a bit of a poser and actually those pictures that she
40:04posted were to present a completely different life to what she was living.
40:08Um, I think what didn't help her was the fact that she'd actually spent 12 months running around Europe undertaking
40:14various activities.
40:16Perhaps if it had just been one incident, the judge may have been more receptive to it, but the fact
40:21that we could show so many posts throughout that 12 month period when she was allegedly in such significant pain
40:28that she was taking these painkillers every day and needed all that assistance, it just didn't add up.
40:37The judge was less than convinced by her explanations and concluded that her evidence was improbable and inconsistent.
40:44He found her to be fundamentally dishonest.
40:48Costs were awarded.
40:49Um, they were awarded in the sum of just under £5,000.
40:56She tripped herself up ultimately, but what's more bizarre is that she would have known that those posts were out
41:02there.
41:03So, um, she clearly didn't expect those investigations to be undertaken.
41:07I mean, there were public investigations she had left them for all to see.
41:14I'm sure the claimant regrets having proceeded with the claim and perhaps that's a lesson for her in relation to,
41:24um, arrogance and the process and thinking that she might pull the wool over the court's eyes.
41:30For Sarah, there's a clear moral to this story.
41:34You can't lie and then you can't change your story when you're found out.
41:39Um, and you can't try and hide the truth either from the court because, yeah, the court will find you
41:46fundamentally dishonest where they're not satisfied that you have been genuine.
41:50Thank you so much.
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