- 6 hours ago
Rogue Claimers - Season 2 Episode 9
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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 just under
00:3415 fake claims every hour armed with the latest fraud busting technology subject out the vehicle
00:42including covert surveillance systems sophisticated data analysis techniques
00:47and specially trained fraud investigators oh 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 five-figure bill for a local council when a claimant has a terrible fall the amount that was
01:15in
01:15the region of 65 000 pounds they were also suggesting that future care was 15 000 pounds a
01:21year because she had pretty much no functionality in that arm at all one opportunist attempt to cash
01:27in with a mobile phone scam is put on hold by investigators you are using the direct replacement
01:33for a change which means that that phone can't have been lost in the circumstances which you stated
01:40and in america an ex-wife who's the beneficiary of a life insurance policy can't resist trying to cash
01:46in whatever the cost you are the subject of an investigation for what or solicitation for murder for hire
02:02insurers can have all sorts of customers looking for cover builders airlines film sets even your local council
02:11because life isn't predictable and accidents can happen anywhere and everywhere
02:19so whether you're a stunt woman paid to fall or an unsuspecting member of the public out for a walk
02:25if someone created the circumstances that caused your accident compensation money could be coming your way
02:34when a member of the public claimed they'd had a particularly nasty fall on the pavement
02:39the local authority responsible for maintaining it called on zurich
02:44we ensure local authority and the council received a claim from a woman who
02:48said that she'd fallen in the street tripped in a pothole and injured her elbow badly
02:55she must have taken the brunt of her fall on the elbow and caused it to smash so it was
03:00a fairly nasty injury
03:03when her medical evidence came in scott could see the extent of the damage the fall had had on her
03:10she'd been in hospital she had to have surgery on her elbow and a plate inserted so there's no question
03:16that she
03:17has actually suffered a genuine injury and something that ultimately she would receive compensation for
03:23if the accident had happened because the street wasn't properly maintained like the woman was claiming
03:29then the council would be responsible but how much would the claimant be eligible for if you were to assess
03:35the injury and the likely
03:36prognosis in terms of recovery time and care it was probably worth between 15 and 20 000 pounds
03:43and the claimant could end up being entitled to more as she seemed to be in a bad way people
03:48recover
03:49differently with accidents and injuries with some people it can lead to all sorts of other ailments
03:54such as anxiety and depression and that's what she was saying she was suffering from
03:59in this case as well as the effects of the injury it was suggested that she required care she was
04:07finding it difficult doing everyday chores and even things as getting dressed she relied on her husband
04:14and her daughter to help her significantly so she in effect lost the whole functionality of her arm
04:20over a prolonged period which was adding to the claim considerably what had started off as being a 20 000
04:28pound settlement figure was growing as time passed two years after the accident and the claim as presented
04:37was suggesting that she'd received considerable care since the accident and the amount that her solicitors
04:43put on that was in the region of 65 000 pounds they were also suggesting that future care
04:49was 15 000 pounds a year because she had pretty much no functionality in that arm at all
04:56the figure had more than tripled and it was giving scott concerns
05:01the amount of care claim that was being presented plus the future prognosis compared to the injury
05:08meant they were really suspicious plus scott knows about the pitfalls or rather potholes around potential
05:15claims where there's going to be an insurance payout some people think that's an opportunity to
05:20exaggerate because the more it's exaggerated the more potentially they could get in order to determine
05:26if any exaggeration had taken place scott took drastic measures
05:34surveillance is not something we do very often but it's absolutely vital on cases to provide
05:40an independent view of what's actually happening all we've got at the stage of medical reporting
05:46is a doctor's word for it or hard work for it but to actually film somebody out in everyday life
05:53you can pretty accurately assess what they're able to do and what they're not able to do
05:58so an undercover investigator was sent out to gather evidence
06:04so we can see in the surveillance the first time she's at the medical appointment and she's
06:10clearly suffering with her elbow she's holding her elbow and looking in quite some discomfort so
06:15that's suggesting that she is injured in the manner that she's suggesting
06:22however on the second period of surveillance a few days later that was the game-changing moment because
06:28an arm that she would give us the impression was not able to function at all she can be seen
06:33to be
06:34closing a car door carrying shopping bags in for quite a prolonged period she had a bag over her left
06:40shoulder so this arm that was according to them completely out of use all of a sudden is functioning
06:46normally and this is somebody who as part of her claim suggested that she'd become somewhat of a
06:52social recluse so she wasn't out and about nearly as much as she used to be but yet here she
06:58is
06:58shopping and carrying the bags in her left hand so this surveillance footage here is absolutely dynamite
07:07in terms of verifying our suspicions that she was exaggerating her claim not just that this woman
07:16was not unfamiliar with the claims process she had made several whiplash claims in the past so when
07:22you put everything in the round this was somebody who undoubtedly set about trying to defraud us by
07:27exaggerating her claim zurich was prepared it was time to give her and her claim the elbow and take the
07:36whole case to court we don't run cases to trial lightly we run cases to trial where we believe
07:44that we've got a case to defend where people are being dishonest the injury had been genuine though
07:51and it was caused by the pothole so could she still walk away with some compensation during the trial the
07:59judge assessed all the evidence that was put forward and crucially surveillance footage as well
08:05the judge agreed that this woman had grossly exaggerated her care claim and therefore
08:11she was entitled to nothing so somebody who had a compensation claim for a fairly nasty injury walks
08:18out of court with nothing and this was money she was entitled to so a double blow to her and
08:26a fantastic
08:27win for zurich and its client where fraudsters are paid money by local authorities and insurers
08:35that money could be better spent elsewhere through local services so it's really quite unacceptable for
08:41somebody to be doing that against the council
08:50later a farmer on the fiddle forgets that the bus he claims hit his van was covered in cameras when
08:57i looked back at it i wasn't even convinced he'd hit the vehicle at all
09:14the festive season in small town america people make the most of their break and enjoy some r r r
09:22that's what's going to happen to you and i don't know what's going to happen but peace and goodwill were
09:24the last things on the mind of one criminal in herriman utah
09:35on the 27th of december 2016 officers with a search warrant paid an urgent visit to canary bird cove
09:44homeowner 69 year old linda gilman had no criminal record she had a hand in a few small businesses
09:50and was doing well financially so why did officers need to see her
09:57six days before christmas they'd received a tip-off from christian olsen a handyman who worked for linda
10:05she'd been married three times and christian was suggesting to the police
10:09that the life of one of linda's ex-husbands was in danger christian detective adamson hello
10:16so give me kind of the reader's digest version of what's going on and kind of give me the
10:21the well she approached me a few months ago about she being linda and yeah about taking out her ex
10:30-husband
10:31and said that you know she would pay all this money to to have him taken out and i
10:39kind of joked it off with her and laughed about it and she kind of persisted from that point
10:45um yesterday she had called me just freaking out because she has to pay more money out to his life
10:52insurance policy and why is it misdone and and yada yada and so today i dug through my truck and
11:00found
11:01the paper she gave me with his name and address and came over here to let him know so what
11:07was the
11:07agreement what was she offering to she offered the five thousand up front and then after he was gone
11:13and you know that it was confirmed and she was going to give a portion of the um insurance life
11:21insurance policy on it okay did she say how much that is or a hundred thousand that's the total policy
11:28no no the total policies are up in the millions like at least two million from what i understand
11:34and she's paying 15 000 a month on them and she's offered to pay you a hundred thousand yeah okay
11:43dwayne gilman had been divorced from linda for six years and he must have been shocked to receive
11:48a visit from a stranger telling him what she was planning but he told detective adamson he was aware
11:55of one of the insurance policies i knew she had about a 500 000 insurance policy on me because i've
12:04had
12:04that through my work i work for a law firm i'm an attorney i did not know there was more
12:12policies on me
12:14uh if there is i mean more than than that uh it was not a pleasant divorce it was a
12:24difficult one
12:25but they divorced years ago so what had triggered linda to want dwayne out of the frame permanently
12:32so no recent contact or anything that would have started up an issue between the two of you there's
12:41nothing i mean it was approximately i don't know nine months maybe a year ago that the decree of divorce
12:50was modified to reduce the amount of the alimony from 3500 down to what it is now which subtracts out
13:00the amount she's getting from social security linda was a beneficiary of dwayne's life insurance policy
13:08and her payments had changed according to christian olsen dwayne was on borrowed time
13:15did she specify how she wanted you to kill him in a way that it didn't look like he was
13:20murdered like
13:21it was a drug overdose or something okay christian hadn't really taken her seriously until she persisted
13:29he knows her and suggests how the police could best gather evidence against her if i could if i could
13:36have like a wire or something and saying that it's getting taken care of then she would openly talk about
13:42i know she would the following day christian olsen is prepared by officers who give him a wire to record
13:51conversations with linda gilman we're not constrained by time don't be in a rush to get out of there let
13:58her talk let her say what she wants to say you guys are ready for a long day so what
14:03i need her to lead
14:04the conversation i don't want you to lead her into saying things i want you to lead her into saying
14:10things
14:11christian was under pressure to deliver and linda didn't disappoint
14:16you can hear her on the wire recording giving christian a ring her idea was this could be used
14:22as currency for the person carrying out the hit i'm not going to try and get him for this just
14:28this
14:30that'd be nice but be damn sure that he's willing to take that and tell you no problems
14:36that if you went to a jewelry store and bought this from a jeweler today it would be at least
14:4115 000
14:42and probably be closer to 20 22 000 now later that day christian updates detective adamson
14:51and passes back the recorder just kind of went from there the hard part was just like freaking
14:57looking around the face you know they listen to the recording which includes linda coaching christian
15:04on how to negotiate with the potential hitman lay it out and lay it out harshly this is it
15:11you screw up here there isn't going to be any money even if you take him out if you screw
15:18up
15:18and there's an investigation that comes back to her in any way there's not going to be a payout
15:25that is the law that's the law
15:31it's a good start and when christian returns to see linda with the wire again she digs herself even deeper
15:39so he's planning on going tonight really yeah what do you do break him i'm not sure exactly what he's
15:48going to do i mean i made it clear like that you wanted no suspicion so
16:14she's confident and deadly suggesting that dwayne is not the only one vulnerable
16:20his current wife is too and linda is willing to pay it might make it easier she's gone too
16:28really well don't you think no witness nothing another 10 grand another 10 grand
16:34yeah so it's 25 less the value i'm sure he'll like that it'll be cleaner if he takes them both
16:45with two people's lives under threat and money in the frame the police had what they needed to
16:51arrest linda and bring her in for questioning i'm detective adamson with the unified police department
16:58you're the subject of an investigation for solicitation for murder for hire okay who
17:05i'm not willing to give you that information just yet okay well i'm asking you some questions
17:12to get some background on you okay okay we're investigating a case where you're the suspect
17:17who has instigated a solicitation for someone to kill another person who who and who who who is that
17:27telling you this story and who is the we'll get there who's the we'll get there you're jumping
17:32ahead in the story though okay well you need all right tell me what's going on i'm getting it's clear
17:39she's keen on asking questions too she did study at law school and her ex-husband dwayne warned
17:46officers she was litigious why can't you tell me what's going on because i i hold all the cards okay
17:53and i'm keeping all the cards and i'll show you a card here and i'll show you a card there
17:57but you're
17:57the subject of an investigation and i'm not going to dump everything on the table for you to look at
18:01it and then decide how you want to answer my questions at this point he does seem to have the
18:07upper hand and he's about to play his ace have you been engaged in a conversation with anybody about
18:13having someone killed no you haven't no so when i play recordings of that conversation what are you
18:18going to say where you're on the recording talking about it you're kidding me no i'm not kidding you
18:24do you think i'm wasting your time you think i'd come to your house and try to kick your door
18:27down
18:27with a search warrant because i made something up i don't know i don't know i don't know i know
18:33i have hours of recordings of you hours you talking on a recording about paying someone to have someone
18:40else killed that's what we're doing here in the last week in the last 24 hours
18:54play it for me we're not going to play it for you right now we're going to play it in
18:57court why
18:58why should i play it for you like i said before i have all the cards i i have a
19:03royal flush and you
19:04have nothing not quite nothing she's got tenacity in spades and it's starting to wear down detective
19:12adamson who would i be talking linda linda who would i be talking to who think about what you've done
19:20in
19:20the last 24 hours did you talk to anybody about having them make arrangements to murder your ex-husband
19:29would it really matter yes of course it does why of course it does how would that make a difference
19:35i don't even know who it is we're talking about until we we're talking about you paying to have
19:41duane killed duane it's duane if it makes a difference absolutely it's okay it's duane yeah
19:49she's finally got the evidence the police didn't want her to know and she's not stopping there
19:55leave me there recording why because it's okay you're telling me in the last 24 hours
20:06wait right here for that we'll be right back
20:08just wait here have a drink can i get a little bit more please yeah finish that one first
20:38do you recognize your voice could be me but i no it could also not be me
20:49let's conclude the interview on december 27th possibly 14 58 hours
20:56can i get one more drink before i go
20:59she's admitted nothing yet still has officers at her beck and call putting water to her lips
21:15linda gilman was tried in march 2018 and her plea was not guilty to both charges
21:23she was found guilty of one count of criminal solicitation to commit the murder of duane
21:28gilman but acquitted of trying to have her ex-husband's wife killed
21:34her slippery pattern of stalling seen in the interview room continued she managed to get her sentencing postponed eight times
21:44finally seven months after her trial linda gilman was sentenced and sent to jail where she could spend the rest
21:51of her life
22:01still to come a fraudster protests their innocence when they're caught scamming a holiday company
22:07let's just discontinue the conversation because i think you're making me feel
22:11like i've done something wrong and i really don't feel like i have spoiler alert she has
22:32many of us have had the misfortune of losing our mobile phone they may be small but they're expensive
22:39and with the cost of handsets going up and up more and more of us are taking out mobile phone
22:45insurance
22:45companies like assurance deal with a mountain of claims a month
22:50so andy morris and his team have a well-tuned antenna for picking up if a claim is genuine or
22:56not
22:58this particular claimant stated that she'd lost her phone whilst out shopping and she had numerous bags
23:04and the bag that the phone was in had just disappeared and on the face of it the original evidence
23:11that the
23:11claimant was stating appeared quite normal right basically um i went to shopping yesterday um and
23:20i had a lot of bags with me obviously as you can imagine when i got home i just cannot
23:25find a bag that
23:26had my phone and i can't find it anywhere i've i went back i've searched every single shop um believe
23:33it or not i'm not even bothered about the phone as much as i am about the pictures of my
23:36daughter who
23:37was born you know i've been wanting to go and i've lost everything there basically so yeah and it
23:42was just all in that that five minutes ago right and also i'm sorry to hear but hopefully we'll be
23:48able to help you get this water as soon as possible so everything seems straightforward that was about
23:55to change while we were processing the initial claim based on the information provided by this claimant
24:02uh it appeared strange because we identified that the very same handset uh which has an imei number
24:11which is a a number that every phone has to makes it unique to that phone that that handset had
24:17gone
24:18back to the manufacturer and that it had been replaced but that wasn't the only anomaly what we were also
24:26able to prove from our records and the data sources was that she was using that phone with a new
24:33sim card
24:34so that there was no loss at all with this new information to hand a further call was made to
24:40the claimant so i'm just calling in relation to the claim itself what i want you to do now is
24:44just
24:44clarify with you exactly what happened and where we're going to get with this from here okay yeah okay
24:50so as part of this when we clarified the usage of the phone that was lost um there was um
24:55some
24:56information that showed it in the possession of a repair center as we've not received much information
25:02but regarding that we did conduct some additional checks in relation to the imi directly um to which
25:08we've received notification from them that as of the 14th of december that the phone was taken into
25:15store to be exchanged right and we've got the imi number that it's been replaced with on our date
25:21and checks the usage of that imi number right now are you aware of this exchange taking place no i'm
25:29not
25:30you're not okay so the network has got back to us with what mobile number has been using that
25:34replacement find the i number and it's this number i'm speaking to you on right so you're in possession
25:41of the replacement phone and you're using the replacement at this point surely the claimant
25:46would concede defeat the replacement is in your possession right how can that be the penny just wasn't
25:54dropping that assurance knew the claimant was using the phone that had been given to her as a
25:59replacement i can't really answer the question that you're asking me there but the information
26:04i have in front of me here is that the day the exchange took place is the day that your
26:09sim card
26:09was placed into that phone right the day i left my phone i borrowed a phone off my sister
26:19and i put my team into that so what are you saying that my sister's taken my phone and had
26:24it
26:24replaced i'm not saying that's the only thing i can think of my sim card i went and had changed
26:30i've
26:31got a new sim card okay what date was that that was on that same day when i lost my
26:36phone
26:38yep so that would suggest then it's the replacement sim card that's in there to replace phone
26:43no well i need to speak to my sister then because you see this is what you're saying
26:46she's been into the store with my old phone and then given me this one until she says oh
26:53once would you get your um replacement there so what you're saying to me is that she's provided
26:58you with a loan phone save make a model whilst you were waiting for your claims to go through
27:03but you're not aware that it was the replacement that was directly exchanged now there's getting
27:09your siblings to take the rap and this one would have a lot to answer for i don't know whether
27:14she
27:14had a sister or indeed whether her sister was involved but she blamed her sister for the activity
27:21i need to advise you on what's going on with this claim now irrespective of what happens with your
27:27sister we can't write you with this claim you are using the direct replacement for exchange which
27:33means that that phone can't have been lost in circumstances when she stated the replacement is
27:39in your possession which means the claim can't be processed what i find strange about this case is
27:45the phone she was claiming for irrefutably while sitting at the manufacturer she had benefited from
27:54a replacement device directly from that manufacturer and potentially didn't realize the collaboration
28:02that goes on between the industry between insurers manufacturers and the network operators themselves
28:09the claim itself will be closed we're not going to process any further but we will be placing a flag
28:14on the account for future claims does that affect my credit ratings and things like that now we have
28:19nothing to do with your credit rating no this is just a claim history sorry yes carry on so the
28:24claims
28:25that are made across the across the insurance industry will be looked into in more detail but your
28:30credit rating will be affected right that's fine okay thank you she might not have messed up her credit
28:37rating but there are still consequences i'm not sure this particular claimant understood the impact
28:44of her actions not only in terms of this particular insurance fraud but also wider in terms of providing
28:52misleading information and what that would affect further on in her life with the black mark against
29:00her name not only will she have difficulty getting insurance in the future but her premiums could go up
29:05and sadly ours could too our responsibility is to protect the honest customers insurance fraud cost the
29:14industry cost uk consumers over 1.3 billion pounds so why should good honest customers be paying for
29:23people who are effectively defrauding us all
29:35driving a 10 ton bus all day isn't without its challenges and drivers have to cope with everything
29:41from traffic jams to angry passengers
29:47first group is one of the country's largest bus operators with almost 20 000 drivers and when claims
29:54are made against them its team steps in to establish the real course of events
30:00when it comes to bogus claims against the company lee ingram has seen it all but this next case even
30:06had
30:07him scratching his head this was an incident that came to us following the report of a bus going past
30:13a stationary van and being alleged that the buses managed to catch the side of the van and the door
30:19as it's going by
30:24according to the third party the impact was of a sufficient severity to cause the vehicle to be
30:29rocked from side to side this in turn of causing to be thrown about in the van and sustained personal
30:36injuries soft tissue injuries to the neck and ligament damage to the right shoulder
30:44this sounds nasty so checks were made when we look back through his accident history we found out
30:51that he had a number of previous accidents and made personal injury claims on those as well
30:58whenever you find out details of previous incidents you have to investigate a little bit
31:04deeper because you never know whether you're dealing with a serial claimant or just someone who's
31:08really really unlucky in this case costs were mounted in addition to his injuries and the cost of
31:16repairing his vehicle he's got quite a physical job he's a farmer running his own small holding so he's
31:23had to employ a farmhand to work for him for a year at the cost of seven thousand two hundred
31:28pounds for
31:29the year's work just to help out with the more physical aspect he's also had to fund his own
31:34physiotherapy treatment the total value of this claim that was submitted was for eleven and a half
31:40thousand pounds the farmer was suggesting the prang had a significant impact on his vehicle
31:48initially the third party claimed that it was just wing mirror damage to his vehicle but that
31:53subsequently turned out to be damaged to the whole side of the van the door was damaged and also the
31:59central pillar of the vehicle bus driver's version of events is that as he was passing this van he's
32:08realized he's got a little bit close but he wasn't actually aware that he'd even made contact with the
32:14vehicle until the driver had caught up with him a bit later on first group had to balance two versions
32:20of
32:20events we've now got the situation where our driver is saying that at very worst this is a very minor
32:27collision maybe he's clipped the wing mirror on the other hand you've got the third party saying
32:31that we've virtually stoved in the door on the side of his van two very different impacts there
32:38and the only way to resolve this was to dig a little deeper we instructed a forensic engineer
32:44just have a look at the car and see what the sort of damage he could see from it
32:49now there was damage to the door so something had hit that door but the forensic engineer said that
32:55the damage was of a nature where it was on the edge of the door and also some creasing around
33:00the hinge
33:01area now to him this suggests that the door was open at the time of the collision
33:08the third party gave no suggestion that he'd open the door at the time and yet the forensic engineer
33:15was saying that's the only real way that that door could have been damaged in that manner
33:21luckily all first group buses have a number of on-board cameras
33:25always recording and ready to help bring the truth to any dispute
33:31when we reviewed the footage of this case it didn't show what the third party was saying had happened
33:40looking at the footage that door wasn't open it stayed the same from the time the bus went past
33:45the vehicle and all the way through it definitely wasn't open the driver wasn't sure whether he'd
33:53click the wing mirror or not when i look back at it i wasn't even convinced he'd hit the vehicle
33:57at all
34:01from every available angle it looks like the bus hasn't touched even the wing mirror
34:10and you can see that as the bus passes the van none of the passengers react to any sounds or
34:16jolts
34:22so either the damage had occurred before the bus incident or afterwards but not when the third
34:28party was claiming
34:34in fact the farmer with his van had a loose grasp on time frames amongst the evidence submitted to support
34:41the claim for the extra farmhand help was a letter from the farmhand himself just saying that he'd
34:50started work from a certain date when we looked at that letter the date was actually three weeks before
34:57the accident this guy was already being employed by the claimant before why did he think he was going
35:03to get away with that perhaps our farmer had a crystal ball but this wasn't helping his case
35:10i've got a lot of operation for the farming community and would love to help out but his plan
35:16to get us to pay for it was just seeded in a field of dreams
35:21first group sent the forensic and video evidence to the claimant's solicitors
35:26we pointed out to them that if they were going to proceed we were going to try and get finding
35:30a fundamental dishonesty against their client which would impose a hefty cost penalty against them
35:36uh they quickly dropped their claim after that one of the hobbies of the claimant was clay pigeon
35:44shooting i think in this case the cctv evidence was enough to ensure that this spurious claim was shot
35:51out of the sky for most of us a holiday is a chance to relax and unwind but for fraudsters
36:07and
36:08opportunists there is no rest for the wicked claims handler sega is a charles taylor company that has
36:15dealt with plenty of tricky travelers attempting to cash in on their holiday insurance policies when they
36:20have no right to do so the policyholder made a claim for the cancellation of a holiday to greece
36:27this was a classic case of a travel insurance policy coming to the rescue when you've had to
36:33unexpectedly cancel your holiday the policyholder was a woman who had booked a five-day break starting
36:41on the 19th of july but just before departure her husband received a letter confirming an operation
36:4710 days later she contacted sega to see what they could do about their holiday
36:55what did you become aware that you'd need to cancel your holiday um i think we're getting
37:00to the point sort of in the last day um it's my husband's back and the spinal surgeon said well
37:09you've
37:09got no choice you need to have the op so we've gone ahead with the op and it's been very
37:14touch and
37:14go whether we can fly on saturday or not um and we're now coming to the point where we don't
37:19think
37:19you can get on the plane because the advice now from the consultant is probably not so it's not ideal
37:26i just want to you know make sure if i cancel it that we are covered which country was it
37:31you reduced
37:31travel to greece uh well it's time to bring me in greece do you know how much it is that
37:37you've paid in
37:38total for the holiday so i've got the hotel directly yeah 5054 euros i'm just trying to find the flights
37:47hold on i think
37:50and 861 and 16 pence the car parking with 104 18. the hotel itself it says very chain and
38:00non-refundable um for all of it and we've paid up front
38:10when the claim came in it detailed all the costs and confirmed the flights could be taken later in the
38:16year but with accommodation alone costing more than 5000 euros for a five-day break
38:22siga was cautious about offering an immediate payout we decided to make some additional checks with the
38:30accommodation provider and the hotel and what they sent back to us was extremely concerning
38:37they told us that the policyholder had in fact moved the holiday from august to october
38:46not only that but the accommodation firm had bent over backwards to ensure that its customers were
38:52not left out of pocket allowing them free use of their facilities and minibar up to the cost of
38:58their original booking it didn't appear that she had a financial loss nor had a valid claim
39:05enjoying such generosity of spirit on the part of the hotel you'd think that the insurance claim would
39:11be quietly dropped well think again despite this she still continued to pursue the claim on her travel
39:19insurance policy with such troubling new evidence the special investigations team got in touch with
39:26the policyholder again you've listed on the claims form that you sent to us that you were able to
39:33revalidate the flights so have you actually revalidated those easy jet flights to travel
39:39on another occasion or is that still outstanding um no it's still outstanding okay and the hotel
39:47itself that you were scheduled to stay in in august of this year have you had any contact with them
39:54since the emails that you sent to us dated the 18th of august regarding your cancellation no i haven't
40:02okay did they give you any refund whatsoever of the 5054
40:07you say nothing nothing nothing okay and have you and your husband traveled outside of the uk
40:16since this particular trip was scheduled to take place no
40:23have you booked to stay again at the same resort since you've cancelled with them for the booking in
40:31august no okay we've made some inquiries with the holiday provider they said that you were able to
40:40reschedule your trip um they've actually told me that you you stayed with them between the 21st and 28th
40:48of october this year no so we've only did that in october so it was not the not the holiday
40:55that we had it was a different holiday
41:01right but when i asked you earlier moments ago you said you haven't traveled out of the uk
41:06whatsoever so why did you not mention that previously i don't know anything i heard you um no i haven't
41:15done anything else right because they've also told me that uh you were notified on the 3rd of october
41:24that you would be entitled to to stay again with them and and that they would honor the cost of
41:31the
41:31room in in sort of credit with regards to the restaurants and the bar facilities at the hotel that's
41:38right but they they wouldn't give us a refund or the same holiday so we were due to go um
41:43on a sunny
41:44holiday in santorini um and we were only offered it in sort of late october so we took a different
41:51holiday with them but it's not the same holiday october may not offer the same high temperatures as
41:57august but they went to the same hotel on the same deal if you were told on the 3rd of
42:03october that
42:04you'd be able to use that booking albeit in a different month of the year to the exact same value
42:10you've continued to pursue the claim for that amount despite having in fact come come back from
42:16that holiday and your comments moments ago when you said that you hadn't traveled out of the uk
42:22uh they they concern me because it would have only been i thought you meant other than that
42:28this for us was not a reasonable response the policyholder tried to convince us that there was a
42:33difference between the holiday in august and the holiday in october when in fact it was just simply
42:39a rearranged holiday certainly appears that you've intended to try and claim despite knowing that you
42:45would be able to use that monetary value on a different holiday the 5054 euros won't be considered
42:54as a part of your claim because you have used that booking i can see that the um car parking
43:00is worth
43:00104 pounds 18 to consider um and i'll let you know our position upon that matter in writing to you
43:08as
43:08well okay um well so if we're going to pursue the claim shall we do um what anything with these
43:18lights
43:18or not then because i left those off didn't i how did you travel to centurion in october
43:26did you did you travel with you because i feel like you're getting a little bit
43:32like aggressive or blaming me in some way so i think let's just let's just discontinue the conversation
43:39because i think you're making me feel like i've done something wrong and i really don't feel like
43:45i have an interesting response from someone who's lied we commonly see policyholders who have been
43:52caught out for their fraudulent actions make complaints it's not my intention to come across
43:59as aggressive i merely asked i merely asked you who you traveled with to santorini if it wasn't those easy
44:06jet flights no it was a different one but that doesn't matter i just feel like the conversation is
44:11going in a way where and i'm getting blamed for something and i don't really understand why
44:17a quick check with the airline showed that the dates of their rescheduled flights matched the october
44:23stay in the santorini hotel the woman despite her insistence that this was a different holiday
44:29had gone back to the same hotel and used the same flight operator we refused the claim on the grounds
44:36of
44:36fraud the matter did proceed to a court hearing where the policyholder was later found guilty of
44:44fraud by false representation and was given a fine the woman's attempt to claim for a five-day break
44:51that was actually taken proved a costly mistake if you don't want a criminal record then don't commit
44:58insurance fraud
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