- 8 hours ago
Rogue Claimers - Season 2 Episode 04
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Short filmTranscript
00:06insurance fraud has reached epidemic levels in the UK it's costing us more
00:10than 1.3 billion pounds every year that's almost 3.6 million pounds every
00:16day deliberate crashes bogus personal injuries even phantom pets the fraudsters
00:25are risking more and more to make a quick killing and every year it's adding
00:29around 50 pounds to your insurance bill but insurers are fighting back exposing
00:34just under 15 fake claims every hour armed with the latest fraud busting
00:39technology it's a subject out of vehicle including covert surveillance systems
00:44sophisticated data analysis techniques and specially trained fraud investigators
00:49oh they're catching these chances red-handed instead of getting away
00:55with it even more of these fraudsters are getting caught out this is Road Claimers
01:08today for investigators catch out a claimant trying to cheat his way to a seven-figure payout it's
01:16clear that this person doesn't need 1.3 million pounds of future care and a new 1 million pound
01:21house building for him to ensure he can carry out his daily activities a rumbled opportunist seeks
01:26divine intervention I can see that that person has been using that phone today that you are claiming you have
01:32lost it and all the correspondence of the email showing that you have sold that phone oh my god and
01:39the pub umbrella is drunk and disorderly seemed quite serious hit on the forehead and she also had a hit
01:46to the back of the head
01:54what makes insurance fraud different from many other crimes is that it's often committed by individuals
02:00who are ordinarily law-abiding people but when faced with the prospect of a payout succumb to greed and
02:06temptation insurers lv recently dealt with a case where greed got the better of a claimant by a staggering amount
02:16the accident was reported to us was quite a serious accident our policyholder was driving home
02:20one evening after work lost concentration veered onto the opposite side of the road and had had a head
02:26on collision with the third party whilst lv's policyholder was okay the driver of the other vehicle wasn't so
02:33fortunate this was a really nasty head-on collision the emergency services took four hours to get the
02:39claimant out of his vehicle it was just trapped by his legs the fire brigade had to take the roof
02:43off the
02:43vehicle to extract him before he was transferred to hospital it was then that the severity of the
02:49accident became clear the claimant was very seriously into this accident it brought bones in each of his
02:54limbs dislocated his hip had a fractured spine and suffered a brain injury it was looking like the road
03:00to recovery was going to be a long one as well as a serious physical injuries the claimant also
03:05described psychological issues he had a fear of travel and whenever he got in a vehicle as a passenger
03:09he described breaking out in hot sweats from the outset lv was aware that this was a claim it would
03:15be paying out on our policy order accepted full responsibility for the accident and based on the
03:19facts of the accident we knew we'd have to deal with this person's care and pay their claim the recovery
03:25for this individual was going to be very long even on his initial stay in hospital he had to have
03:29surgery twice to have plates inserted into his body they were then removed in further surgical
03:34procedures sometime afterwards in good faith we dealt with the claim as it was presented to us
03:38we made a substantial offer of 300 000 pounds to sell this person's claim we also installed a wet
03:45room in his property to allow him to wash and bathe himself but this wasn't a claim that was going
03:50to
03:50be settled quickly despite making this offer we weren't able to agree a settlement with the claimant
03:55and he proceeded to issue court proceedings against us with claims like this it's not uncommon for an
04:00agreement not to be reached so at this stage lv had no cause for concern within the court proceedings
04:06is something called a schedule of loss that itemizes each head of claim that the claimant wants to claim
04:11for on this particular occasion that added up to 1.5 million pounds that's five times the offer that
04:16we'd initially made him despite the huge difference in amounts it was possible that lv had simply
04:21underestimated the value of the claim upon receiving this schedule we now need to instruct a team of
04:27experts to understand if this figure quoted was reasonable for settlement that'll include a doctor
04:32to look at the physical injuries a nurse to look at his requirements around the house such as washing
04:36cleaning and general caring for himself we also then had to consider if his property was going to
04:41be suitable for his long-term living conditions the claimant will also instruct similar experts their
04:45own doctor their own care experts and these reports will be submitted to us at this point there
04:50were no red flags and we're happy for the claim to proceed and we look to negotiate settlement
04:55but that was about to change as the claim progressed we got given an updated schedule of loss from the
05:00claimant solicitors this totaled three million pounds which included 1.3 million pounds for his
05:06ongoing care and also 1 million pounds for building a new property by now we're looking at a settlement
05:12figure around 10 times what we originally offered before moving forward any further lv wanted concrete
05:19proof that what was being claimed for was above board the claimant went to go and see our doctor
05:24for his full examination to take place this included a lengthy journey to the doctor's appointment and
05:29also a detailed examination which took around two hours to complete this included carrying out a
05:35reflex test on the various joints however our expert was rather alarmed at some of the reactions the
05:40claimant was screaming out which is not consistent with what the doctor was of anticipated in such an
05:45examination the doctor's report also caused lv to have a knee-jerk reaction upon receipt of this report this
05:52is when we became suspicious of the claimant and decided to look into this matter further with our
05:56concerns on this particular case and the alleged injuries the best way to investigate this type of
06:01broad is covert surveillance having the claimant followed by a team of covert investigators isn't a
06:07decision insurers take lightly but with such a huge claim on the line lv had to be certain
06:14throughout our investigations into this matter it became clear that the claimant alleged he was bedbound
06:19he was unable to wash and care for himself unable to get dressed in the morning he was unable to
06:24drive his vehicle claimants with these type of injuries will often have good days and bad days and
06:29we accept that therefore surveillance has to be carried out over a long period of time and on this
06:33particular occasion we looked at around eight months based on the claim presented to us we didn't
06:38anticipate to see the claimant very much on the surveillance and if we did see him he should have
06:42been in a wheelchair with his carer however we were surprised when the footage came in because we saw far
06:47more
06:48of him than we anticipated when i first saw this footage i couldn't believe what i was seeing having
07:02seen his medical report to say he couldn't get out of bed without aids and now i can see him
07:06driving
07:06around and living a relatively normal life and that's putting it lightly here we can see him with
07:14a small baby putting him in the back of the vehicle as you can see the claimant gets into the
07:18driver's
07:19seat of the car and drives away despite having a female passenger there who could have actually been
07:23the driver based on his claim his alleged fear of travel being bedbound this is not what we'd have
07:32anticipated to see with the surveillance footage painting a very different picture to the one the claimant
07:38would have lv believe the validity of the entire claim was thrown into doubt given our concerns we
07:45started to investigate all the heads of claim again this included the wet room that we previously paid
07:50for to be installed at his house this investigation revealed that the estimate was dated four months
07:55prior to the accident and therefore this was just simply his home improvements and not requirement for
08:00his ongoing care and the continued periods of surveillance did nothing to alleviate lv's doubts
08:09here we can see the claimant getting in and out of the car unassisted
08:15but look carefully i think he's forgotten something
08:25as you can see he's gone back for his walking stick despite going back to the car to get his
08:29stick
08:30he's clearly walking without it now he falls off the curb stumbles but can recover despite these
08:39alleged serious injuries and appears unfazed by it here we can see him at a restaurant two of the
08:45members of staff come to try and put some items in the back of his vehicle but are clearly struggling
08:48to open the boot
08:53our claimant can open it though despite being the one allegedly injured
08:57out comes the claimant opens the boot which is not consistent with what he's told the medical expert
09:04it's clear that this person doesn't need 1.3 million pound of future care
09:08and a new 1 million pound house building for him to ensure he can carry out his daily activities
09:13it didn't take a fraud expert to work out what was going on
09:16having seen the footage it was clear the claimant was exaggerating his injuries and lying to us this is
09:22not what insurance is for we're there to make things right when things go wrong and therefore
09:26we decided to defend this matter given the evidence available to us we decided to make an
09:32application for fundamental dishonesty this meant that even though there were genuine elements of
09:36the claim these would be forfeited due to the gross exaggeration of the fraud unsurprisingly
09:41the prospect of being cross-examined in court was something the claimant was keen to avoid
09:47upon hearing that we intended to make an application for fundamental dishonesty
09:50we soon received a call from the claimant solicitors saying that he wanted to discontinue
09:54his claim we allowed him to do that on the proviso that he paid us back our costs which had
09:59totaled
09:59125 000 pounds we've already received 50 000 pounds from the claimant and we're now pursuing the
10:05additional 75 000. the claimant had seen an opportunity to cash in but rather than being awarded a
10:11life-changing sum of money he now owed it i think what's important to remember here is this is a
10:16very
10:16serious accident with some genuine injuries that we were happy to deal with however this person's
10:21greed has taken over and it's ended up costing him 125 000 pounds
10:32later sparks fly over a solitaire diamond
10:36yeah yeah i'm not a moron i said to the chat yesterday i don't want some cheap jewelry company
10:43knocking me up something that cannot be replayed
10:54smartphones can be used for much more than calls and messages so in the wrong hands it's not just a
11:00gadget at risk but the personal information contained within we can protect them with security and
11:09passwords but the next case dealt with by assurance is a great example of the old adage you can choose
11:15your friends but not your family this claimant stated that after her husband had dropped her off
11:21outside the post office uh she wanted uh to telephone him because there was a really long queue in the
11:27post office he told me to call him when we freeze so he can come back uh and he can
11:33pick us up i said
11:35okay but i didn't notice there is no um battery in my phone it's about two percent battery that time
11:43so i told my son to replace the same card to his mobile handset he got a phone and he
11:50got no contract
11:51and he wasn't uh got a credit that time on his mobile she took out the sim of the phone
11:59put it in
12:00her son's phone telephoned her husband and when she put the phone back in her pocket subsequently she
12:06lost it can you tell me the last time you were able to use that phone before it was lost
12:11on the date when
12:13we reached to the post office the phone was in my hand and i usually put my phone into my
12:19guardigan's
12:20pocket the customer filled out a form for a replacement phone at the market value of 450 pounds
12:29each claim goes through a validation process this involves checking the status of the phone's unique
12:35imei number and the results of these checks are sometimes surprising
12:42we were able to identify that this particular handset through its unique imei was still actually
12:49in use that led to additional investigations to try and ascertain who was using the phone the
12:58investigation team tracked down the current user who had bought the phone through an online marketplace
13:03the actual buyer of that phone was able to produce correspondence and evidence that led us
13:09straight back to the original claimant the lady who was in the post office she had some questions to
13:16answer do you know whether or not this phone has been sold at all no i don't know you don't
13:24do you want
13:25to explain to me how it is that i know somebody else come to be in possession of that phone
13:28i don't know
13:29about anything your phone has been sold this number i'm talking to you on was used as the contact
13:36number of correspondence between yourself and the person who was buying the phone the proof of purchase
13:43that you have sent to us was sent to the person who bought the phone because he has sent me
13:47a copy of
13:48that document and i have that in front of me i have all the email correspondences between that person
13:53and the person who sold the phone which is yourself i can see that that person has been using that
13:58phone it's the day that you are claiming you have lost it and all the correspondence of the email
14:03showing that you have sold that phone the claimant then was as surprised as we were this is my humble
14:11request to you whatever you are saying if that's i myself it's shaking right now what i'm going to do
14:17because i had a relative arrived from back home and they just left yesterday and i am going to find
14:25out because i'm not very good computer person and i'm going to do right now some investigation in my home
14:31and i'll find out who got the phone and who made these things and who's been using my emails oh
14:38my god
14:39who was with you whilst you were out with your son is it just you and him it's no no
14:44no no it's not
14:45just me and him it was uh one lady and one chance they came from back home to our country
14:51and i handed
14:52over my cardigan to just one lady maybe they took the phone from my pocket and they've done something
14:58like this oh my god i don't know how to explain the thing oh my god sorry i'm not this
15:05kind of lady
15:06and i'm really i'm really really sorry it's definitely someone's using my phone because
15:12the inside the phone there was email as well and there was my account was everything inside my phone
15:19all the time is open i don't use any fingers or any password on the phone that doesn't change the
15:25outcome of this claim if anything that's a life lesson that you just learned there isn't it
15:29decision has been made on the claim it's not going to be processed we're not going to accept on the
15:33basis that we have sufficient enough information to support a false claim being made you wish to
15:38dispute that that's your choice conduct your investigation the evidence was damning and the
15:43explanation flimsy but the claimant sounded like she hadn't got much security in place on her phone
15:50leaving it and her vulnerable she obviously realized this and in record time had carried out her own
15:57inquiry within the space of 24 hours she had performed an investigation herself allegedly her sister
16:07had sold her mobile phone she told me yes he got the phone and he sold that phone okay so
16:16where did
16:17your sister live she lived in pakistan in pakistan why did your sister do that i owed him some money
16:24but i
16:25was not giving to her and she told me she'd done that without my permission okay
16:33oh my god so have you forgiven your sister yes i have you have okay i don't think i would
16:41forgive my sister quite so fast but um as the phone has been taken and sold without your permission
16:51that is no classes stolen would you like me to log that as a theft or what do you want
16:57me to do with
16:58this claim do you want me to close it or reopen it what do you want us to do i
17:03just want to do to close
17:05it down and the person who bought the phone she gave me his phone number i did contacted him and
17:13she
17:13already paid for the phone so it's okay when i'll get the money i will buy another one i don't
17:20want to
17:20be classified this room lost of stolen anymore and we are not going to make any claim against this phone
17:30okay she had benefited the claimant herself because her sister had used the claimant's bank account
17:36details and the cash from the sale had gone into the claimant's bank account so the claimant simply
17:43stated to us don't worry about the claim i'll use the money and buy a new phone with such unusual
17:51circumstances assurance took no further action beyond turning down the claim but false claims are taken very
17:58seriously and there was a sobering warning it's not going to change the fact that we've rejected your
18:04claim and in the future if you didn't need to make a claim for whatever reason in the future
18:09then we would need you to prove your innocence in this claim so we would require a bank statement of
18:15yours and your sisters we would require a crime reference number and you would have to report your
18:20sister to the police insurance fraud in the uk is a very serious matter it costs
18:28the uk consumer over 1.3 billion pounds and we are working really hard as a firm but also
18:35collaboration across the industry to link various sources of data to protect honest customers
18:42and to identify those fraudulent ones
18:52a hot day some bevvies and your best friends sounds like a recipe for a very chilled afternoon
18:59unless of course the weather takes a turn
19:08pub chain jd weatherspoon was faced with an injury claim that kicked up a bit of a storm
19:14a female customer alleged that some summer drinks had left her feeling a lot worse for wear
19:20so they called in their legal expert leandro kelly to get to the bottom of it we received a claim
19:27form
19:27from solicitors on behalf of a customer who attended one of our pubs the customer said that she went into
19:34um our beer garden and was having drinks with a group of friends um it was a fairly windy day
19:40she says that one of the garden table umbrellas lifted from its base flew two meters across the
19:46garden and landed on the table that she was sat and hit her in her head the customer was claiming
19:52that
19:52she was hit on the forehead and that she also had a hit to the back of the head and
19:56that she was also
19:57suffering from tinnitus very traumatic seemed quite serious but the offending parasol didn't just strike
20:04once there was also another individual who was sat around the table with our customer she also said
20:11that she was hit in the forehead by the umbrella very unusual that one garden umbrella would hit two
20:16people at the same time in the same location they were saying that they had the same injuries they
20:21had the same side effects they both attended hospital they both went to their gp on the same
20:27day their stories matched exactly and if carbon copy claims weren't suspicious enough an additional fact
20:34also didn't quite add up they even had matching dates of birth alarm bells started ringing it's highly
20:41unusual that two people can suffer the exact same injuries have the same symptoms for one accident
20:48the details of the claim were very unusual so jd weatherspoon investigated further her claim was
20:55actually valued at 18 000 pounds um we thought it was very um interesting someone who would have had
21:02a serious knock to the head uh would be claiming more money because we'd expect them to be off work
21:07we'd be expecting them to claim for care and assistance from family members but it was very specific it was
21:1318 000 pounds that the claim form was limited to having doubts already leandro dug deeper cctv is
21:21extremely important because it is real-time evidence if it's caught on cctv there's no disputing it
21:28so from the footage we can see the customer and her friends coming into the garden to sit at
21:33table to have a few drinks check however we can see that the wind starts blowing
21:38and a few of the umbrellas in the garden start to move check there is one umbrella that does get
21:44lifted away from its fixture brace yourselves you're about to see a terrible accident
21:51nah you didn't miss it top left hand corner a folded umbrella flops over
22:01so not exactly the drunk and disorderly behavior we were expecting from the brolly
22:06if both customers were hit in the head we'd expect to see her friends react no one moved
22:12no one was disturbed they carried on drinking and having a good time leandro hoped this evidence
22:18would calm the legal storm that was brewing we put this to both claimants and let them know that we
22:24thought that their claims weren't genuine one of the customers disappeared we never heard from that
22:30customer again the other customer however decided that she wanted to proceed to court she wanted to
22:36get compensation she wanted her day in court and she was going to stop at nothing until she did
22:41it was beginning to look like an expensive round for jd weatherspoon when the customer submitted her
22:47claim into court it was very surprising that the claim had actually doubled in value from about
22:5418 000 pounds to 39 000 pounds the customer had obtained medical reports from orthopedic experts
23:02as the trial progressed the judge had questions when the judge asked the customer why she said that she
23:09had the injuries that she said she had the customer said that she was actually told by her gp that
23:16she had
23:17suffered concussion and the other injuries and that she never said that so it looked like things were
23:23unraveling and of course leandro had something that would take the wind out of her sails when we played the
23:29cctv footage for the court
23:31the judge saw that the accident didn't happen as the customer said it did the judge immediately
23:37stopped the trial the judge found that based on the evidence the customer was fundamentally dishonest
23:43because she'd attempted to make a claim for compensation when she wasn't injured having her
23:49claim thrown out by the judge was a blow but something even more sobering was coming the claimant's way
23:56and he actually awarded us costs in the amount of 15 000 pounds against the customer it's very sad the
24:03customer wanted 39 000 pounds she ended up having to pay us 15 000 pounds the customer wasn't surprised
24:10she was shell-shocked it's almost as if she couldn't believe this has actually happened after the trial
24:18leandra contacted her solicitors but they said she had disappeared and no longer represented her but
24:25that's not the end of the story we now have a county court judgment against this customer and we're
24:32actually pursuing her for that money our opinion is that making claims for compensation when they're not
24:38genuine is not worth it they carry serious consequences financially legally ultimately
24:47people can be imprisoned for making fraudulent claims
24:55still to come a bump on the bumper with plenty of twists and turns he said he could get
25:02pre-existing damage to his vehicle prepared if he agreed to participate in a sham accident
25:16when it comes to jewelry insurers offer policyholders a choice of either cash repair
25:22or replace if their item gets damaged or goes missing lmg specializes in managing claims for jewelry
25:29watches and other valuables and every year 16 000 of these claims are because of accidental loss
25:40we received the claim for the loss of a diamond ring which we'd been told had been lost while out
25:44shopping we had no reason to believe that the claim wasn't genuine in itself in order to support
25:50the claim the customer sent us a photograph showing the diamond certificate and the detailed
25:54valuation of the ring with all the paperwork in lmg got one of its handlers to gather more information
26:00we've been appointed just to take some details on the claim
26:04no problem of course what it's my aim to do is to talk to you about its background and description
26:08so i can help to assess what's an up-to-date value on on this ring yeah did you not
26:15get the
26:16photograph and the valuation certificate you know it's quite an antique ring but here we are yeah it's
26:22four thousand five hundred pounds the actual valuation yeah 0.71 carat okay g color si1 clarity
26:32has it been lost while you've been out and about has it or yes when i'm shopping you know it's
26:37so hard
26:38because my husband's going to be the one that's going to have to find another antique to try and you
26:42know replace people with his ring so we've got a personal jewelry service yeah i've already mentioned that
26:50and i said well i'd rather just get my husband to replace it himself thank you well that's
26:55very sentimental yeah it's very very difficult to replace and honestly i can't tell you i've
27:00quite a week yeah absolutely it's very distressing and frustrating as well isn't it absolutely
27:05frustrating and uh well leave it with us and we'll sort of um you know get get the value on
27:11there
27:12because it's got the specific diamond qualities on there so that's that's brilliant the certificate was
27:19issued three years previously so after looking at the increased value they had a settlement figure
27:25for the claim potentially the replacement cost of the ring was 6050 pounds once we discussed the
27:31replacement cost of the ring we contacted the customer to discuss settlement of the claim just to
27:36let you know that our jewelers have valued the item on the claim now and we're in a position to
27:42discuss
27:42the replacement of the piece with you firstly let me stop you there i already spoke to them
27:48so why are you trying to contact me after i spoke to a gentleman yesterday
27:54it's to discuss the settlement of the claim unless yes yeah i'm not a moron i know the settlement has
28:02been cl it's been settled the claim right was this discussed with the insurance company by any
28:09this was discussed yesterday and i'm getting very fed up of all these phones i'm very poorly and i'm
28:15in bed and i've got people ringing me it's already been settled okay i i do apologize for sort of
28:22miscommunication there um so did they discuss with you what the cash settlement figure for the claim
28:28would be four and a half thousand four and a half thousand was that discussed with the insurance
28:34company i i don't know the gentleman who rang yesterday the gentleman that spoke to me yesterday
28:41um oh god i can't remember you know whilst the claimant was adamant that everything had been
28:49settled lmg had not been the ones to call her the previous day so needed to find out more before
28:55closing
28:55the file we we were we as standard are asked by your insurance company to settle the claim
29:01on their behalf now if you've spoken with another party about this and agreed settlement with them
29:07they've not passed that information on towards they said you know we were originally supposed to be
29:11discussing settlement with you but if that's when you say settlement no no no listen when you say
29:17this is settlement fraud what does that mean to you to discuss how it is you want to move forward
29:25with the claim but it sounds like did that with someone else yesterday but that wasn't from our
29:29company but i'm just apologizing that we have called you today but the company you spoke with yesterday
29:36did not have not inform us listen when you say settlement because you're not letting anybody speak
29:41you're just speaking your lingo over the phone to me i said to the chat yesterday i don't want some
29:47cheap jewelry company knocking me up something that cannot be replaced it was my mother's ring
29:53who died of cancer right no one can replace that and i said i am sorry that he hasn't done
30:00that and
30:01that do not apologize on behalf of somebody else because you make yourself look stupid all i'm asking
30:07for is whoever's told you to ring me get them to ring me and i will tear their head off
30:13i'll send
30:14i'll report to them now for you okay wonderful okay thank you all right thank you bye the claimant's
30:20tone didn't go unnoticed an alarm bell started to ring when we're dealing with claims we refer
30:27to a number of fraud indicators and unnaturally aggressive behavior is one of those what we find
30:32is genuine customers submitting a genuine claim are unlikely to behave in such an aggressive manner
30:38after that phone call the claim was referred to our technical team for background checks
30:44and the more they investigated there was a distinct feeling of deja vu
30:49on reviewing the claim the technical team uncovered a previous claim for the same policy
30:53holder using a different address when we looked at the previous claim we realized that the customer
30:59had used the exact same valuation as she had two years previously this demonstrates that if the ring
31:05had been lost two years previously it couldn't have been lost again not only that but the claimant
31:10must have lost track of the fact that she received a settlement of four and a half thousand pounds
31:16so for this customer the claim wasn't paid the policy was voided and it would be very difficult
31:21for them to get an insurance policy through any other insurer
31:32no one is safe from being asked to foot the bill if negligence results in some kind of injury
31:37especially if it's serious and that includes local councils
31:44scott clayton from zurich explains the circumstances of one particular claim that came in it was for personal
31:51injury against the local authority that we insure they said there was a pothole in the road and they
31:56put their foot in it and sustained injury as a result sounds like a fairly plausible story so far
32:03he suggested that he had suffered a knee injury so it was like a tear to his ligaments
32:08on the face of it the claim seemed genuine because there was a defect in the road so if there
32:14was a
32:14defect and someone had actually tripped on it and sustained an injury then on paper
32:18it was possibly one to pay but just how deep would the local authority need to dig
32:24we estimated this claim to be off in the region of 9 000 pounds based on what he was telling
32:28us and
32:29how much he was injured a substantial sum so of course zurich would start to make all the necessary
32:35checks before issuing any cash
32:40as with any claim where there's personal injury alleged we need sight of the medical records
32:45just to validate exactly what's been claiming for is accurate so in this particular case the medical
32:51records came through and it did say that there was an e-injury with everything stacking up it looked
32:58like things had happened just as the claimant said but one thing caught scott's attention
33:04rather strangely he also sent in a photograph of him in the street pointing to the pothole
33:09a memory snap of his trip maybe and we don't normally get that with claimants but it certainly
33:17showed the pothole on this occasion but if this chap thought a snap of the offending pothole would be
33:22enough to rubber stamp his claim then he was sorely mistaken we validate every claim and that includes
33:29looking at the injury and whether it was consistent with what was being alleged and the knee injury in
33:35this case actually the suggestions were that it was more likely to have been caused playing sport
33:40so that's when we became suspicious about what had actually caused the injury to his knee
33:45zurich decided to dig a little deeper the investigations looked into the background of
33:50this claimant and we found out he was a rugby player and quite an active rugby player and so that
33:56was something that we wanted to explore further even though he played rugby it didn't necessarily mean
34:01he hadn't been tackled by a pothole we carried out those inquiries really so we could get an idea
34:07of who we were dealing with but the real dynamite moment in this case was when we found out he
34:12was
34:12playing rugby the day after he said he'd fallen in the street and those inquiries revealed that he
34:19actually was playing on that date but he was taken off or substituted um as a result of an injury
34:25so that then led us to conclude that the injury had actually been caused whilst he was playing rugby
34:31so not only did zurich have evidence from the match reports of the claimant being subbed because of
34:36injury it also discovered something else we also were able to prove that he was playing rugby
34:42subsequent to his injury so he'd recovered and was back on the playing field so this was a fraudulent
34:48claim and it was one that we were obviously keen to put to him and because this was a claim
34:52against
34:52a local authority we referred the matter to the police a call from the police was probably the last
34:58thing he was expecting so they invited the claimant to come in for interview at which point he admitted
35:04that he'd made an entirely fictitious claim the chap said that he'd actually been encouraged by his pals
35:10to make a claim against the council so he kind of blamed it on his pals
35:15they were now on the sidelines and the claimant was sent to the sin bin
35:19because the claimant admitted his guilt he received a police caution so that will remain on his record
35:25and affect potentially any future employment or references that people may
35:29seek against them so it's a harsh lesson that he learned
35:42the reality is that not all collisions on the roads are accidents and there are fraudsters out there who
35:48would deliberately cause crashes to get their hands on some whiplash cash
35:57when a claim came in to dac beechcroft it looked like a simple rear end shunt and it was representing
36:03the shunter
36:07the claim was for a husband and wife who said that they were traveling on the slip road on the
36:12m4 heading
36:13towards london in heavy traffic and they say that the car in front braked because of the heavy traffic
36:19and then the car behind them in which our insured was driving failed to stop in time and just drove
36:25straight into the back of their vehicle
36:30the insured's version of events was very similar he did admit to hitting the rear of the claimant's
36:35vehicle so it was all looking like an open and shut case for the unlucky couple but the person who
36:42had allegedly driven into them was about to put the brakes on and this time early enough the insured
36:51straight away thought that there was something suspect about the accident circumstances and he did
36:56report that to his insurer his version of events it was was that they braked for no apparent reason
37:01inducing the accident this was indicating it could have been a slam on
37:09and something else wasn't right the accident damage to both vehicles according to the insured
37:16that was very minimal so the insurer was very surprised when they received the vehicle damage
37:22claiming from the claimant which was for significant damage to the rear of the vehicle in addition to
37:28this the couple claimed for their injuries the personal injury claims presented by the claimant
37:34uh both were reasonably modest sums and we're only looking at a couple of thousand pounds here
37:39the key driver for this claim was the credit hire recovering storage the total amount amassed in
37:45higher charges was in excess of 170 000 pounds a very steep sum for the replacement car and it was
37:52also looking like whiplash cash wasn't the driving factor for the claimants the whole purpose of the
37:59setup of the claim it wasn't personal injury it was bent metal so accident damage and subsequent hire
38:06at this point dac beechcroft wanted to know exactly what had happened to both cars
38:12part of our investigations we instructed a forensic engineer to inspect both vehicles to see whether the
38:17accident damage was consistent and he determined that it wasn't there was pre-existing damage to the
38:23claimant's vehicle having investigated spoken to the insured and obtained forensic engineering evidence
38:29we were pretty sure that we were dealing with the fraudulent claim with the claimant showing no signs
38:35of doing a u-turn dac beechcroft took decisive action we felt so overwhelmingly strong about defending
38:41this case that we took it to trial civil court proceedings had started and this pair of fraudsters would
38:49soon be before a judge there were two main pieces of evidence which we used to prove that this accident
38:56had been induced the first was the insured and his version of events he was very clear and concise
39:01about how the accident had happened and then second element was the engineering evidence we obtained
39:07forensic engineering evidence which stated that the damage to both vehicles was inconsistent with the
39:13claimant's version of events the claimants at trial came across as really poor witnesses
39:18in terms of their recollection of the accident he accepted under cross-examination that the majority of
39:25the damage wasn't accident related but still continued to ask for damages for another part of the vehicle
39:35at this point the judge ruled that the couple were fundamentally dishonest and ordered them to pay
39:40dac beechcroft's legal fees and that wasn't all he went further and joined in the hire company to
39:47pleadings so that we could also pursue them for our legal fees and the journey didn't end there as
39:55the fraudsters had lied under oath dac beechcroft wanted them to face charges for contempt of court
40:04the claimants continued to deny and they were at fault and they maintained their innocence two days
40:11before the hearing they did however concede that the claims were fabricated so what was the explanation
40:19the claimants had signed statements of truth attached to their witness evidence
40:23they claimed that they actually hadn't seen or read the statements before they'd
40:28signed the statement of truth and only now did one of the claimants allege there was a third party involved
40:35he said that he was introduced to the director of the hire company who had told him that he could
40:41get pre-existing damage to his vehicle repaired if he agreed to participate in a sham accident
40:48and to help he would also put somebody in the vehicle to tell him exactly when to break
40:54to induce the accident the couple was facing accusations of contempt of court
41:03and when the judge made his verdict it wasn't good news
41:08the outcome of the case was that the second claimant his wife was given a six-month suspended
41:13sentence and the first claimant was given a 12-month custodial prison sentence
41:21there are enough tragedies on our uk roads without deliberate slam-ons being orchestrated by fraudsters
41:28who want crash cash so prosecutions ending in jail time should be a deterrent
41:33so i think the message is getting out there but people don't when they do their kind of risk
41:39analysis they just simply think like if i get found out i just won't get a payment well if you
41:44get
41:44found out you'll end up going to prison
41:47so
42:14so
42:15so
42:15so
42:15so
42:15so
42:15so
42:15so
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