- 6 hours ago
Rogue Claimers - Season 2 Episode 15
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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
00:34under 15 fake claims every hour armed with the latest fraud busting technology
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 an outrageous claimant with expensive taste gets caught out
01:24i think this particular individual is without that one of the most persistent and serial fraudsters
01:31that we've encountered a prisoner claiming for an injury forgets the camera never lies
01:38he certainly doesn't fall to the floor as he stated in his statement it's only when he stands up and
01:43picks up two pieces of chair that you actually realize that anything very much has happened
01:48and mother doesn't always know best i don't think this particular customer grasped that this was fraud
01:54i think that it was just an honest mistake and he was just trusting his mother's advice
02:05jetting off on holiday is fun but the journey has challenges after landing you must collect your bags
02:10and head to your hotel ensuring you leave with the luggage you arrived with aviva discovered it wasn't
02:16the only company dealing with a traveler who had a taste for designer labels the claim that was presented to
02:22us was for the loss of an expensive bag and a number of electrical items and devices
02:28he claimed that he had left the bag accidentally in a taxi whilst he was on holiday visiting family
02:35in total the claim was worth approximately 3 500 pounds we went in the house we realized we left
02:41uh having a hold of our holders in the taxi so you're looking to type for the items you left
02:47behind
02:47yes we contacted the police the police have they launched the investigation and they told us to
02:57take this piece of paper to our insurance company in the uk on the face of it it did appear
03:01to be a
03:02genuine claim um the loss was very plausible and the claim was also supported by invoices and documents
03:09what was in the bag that you're looking to claim for it was a cookie holder with wheels black wheels
03:31and you're looking to say perfume your perfume like man's perfume or your wife's perfume
03:49When we investigated the original claim made on a travel insurance policy,
03:54we quickly identified that an identical claim for exactly the same things
03:59had been made on the same day under a home insurance policy in the same name.
04:03Our designer label Loving Clayman was either being over-efficient or chancing his luck.
04:09This was the call he made under his home insurance policy.
04:13You've got your personal belonging cover there, and the sums insured for that is £3,500.
04:20Thank God for that.
04:21When we investigated the claim even further and listened to telephone calls associated to the claims,
04:26we quickly found that it was the same person.
04:29What I'll do is I'll get this claim registered with you just now.
04:33What day did the incident happen, please?
04:35On the 22nd, the day we arrived.
04:37Oh gosh, I see.
04:39And what's happened?
04:39Was it stolen or did you leave at that?
04:41No, what actually happened was we had two bags and my partner, she had her bag.
04:47We got a taxi.
04:48We paid the taxi driver already.
04:50Mm-hmm.
04:51And I got out of the car and they opened the boot and everything.
04:54And then we go, where's my, oh, I think I went in to get my charger or something.
04:59Yeah.
05:00Where's the hold on?
05:00And I asked them, we just got everything out of the boot.
05:02Mm-hmm.
05:04And when you contacted the police, did they give you any reference numbers at all?
05:08They gave me, like, a police report.
05:12They gave me a police report and there's no numbers on that at all.
05:15From what you can see under a phone, anyway.
05:17I got it with me.
05:20This polite claimant on the phone was a real pro.
05:24As well as making two identical claims to Aviva, we also discovered, through the information
05:30that's shared between insurers, that an identical claim had also been made to the RSA insurance
05:35company.
05:36When we did speak to the RSA, it was apparent that it was exactly the same claim for exactly
05:42the same items, with exactly the same documentation again.
05:45As a result of further investigations, they were able to identify multiple policies and
05:51multiple claims with multiple insurers.
05:54He was, in fact, well known to Aviva and had already served a two-year prison sentence
06:00for his fraud habit.
06:01His conviction in 2012 was as a result of us identifying 20 fraudulent claims with a
06:08value of £50,000, all for very similar electrical items and with a very similar MO in as much
06:17as there were different names, different addresses and different bank accounts.
06:22And it emerged that fraud was a family affair.
06:25Whilst he was still under investigation, he took out a further two policies with Aviva in
06:302015.
06:31As a result of that, two claims were made very shortly afterwards, one in the name of his
06:38mother and one in the name of his nephew.
06:40Those two claims were worth £21,000 and £12,000 respectively.
06:44The main protagonist had a number of aliases and he played a complex game.
07:05The claimant may have thought spreading the net wide would make him untraceable, but this
07:10naive assumption was his undoing.
07:12I think he underestimated, in the first place, our ability to join the dots up and connect
07:21policies and claims.
07:22And secondly, the extent to which the industry and insurers shares information between them
07:28to fight fraud.
07:28His spree couldn't last forever and Aviva involved the police.
07:34He was finally charged on 17 counts of fraud to the value of £37,000 and he received a two
07:44-year
07:44custodial sentence.
07:50His mother and nephew were also charged and found to be complicit in his fraud and they
07:57both received suspended sentences as well.
08:00The claimant was a prolific fraudster who'd already done time and just received another
08:06sentence behind bars.
08:07This would be enough to stop most people, but he had one final brazen claim up his sleeve,
08:13this time after the police raid on his home.
08:16To illustrate the audacity of this fraud, before he was convicted, he even submitted a claim
08:23on his mum's policy for damage caused to the door, affecting a forced entry.
08:28I think this particular individual is without doubt one of the most persistent and serial
08:34fraudsters that we've encountered.
08:37This is a good example of insurers' ability to detect fraud, the level to which they're
08:43now collaborating to fight fraud and protect innocent customers.
08:48The industry is increasingly taking a very tough stance against fraud and it's really important
08:55that there are consequences to the fraudsters to deter it in the future.
09:06There are over 120 prisons in the UK with 90,000 inmates.
09:12Despite close guard, the opportunity for fraud remains and some will chance their arms.
09:17HMP Whitemore is a maximum security prison, housing around 460 of the system's most dangerous
09:24male convicts.
09:26As Governor Will Stiles acknowledges, there may be a higher propensity for inmates to
09:31chance a claim, as crime is what led them inside.
09:34There are those people out in society who find every wobbly paving stone and streetlight that's
09:41out of use, I'm sure, and of course you have to remember that within prisons we are dealing
09:45with people who, in large part, are here for serious crime or dishonesty.
09:50So some of those people will try and conduct dishonest activities whilst they're in prison.
09:58There are people in place, like Di Danes, who deals with the varied cases that emerge at
10:03Whitemore Prison.
10:04The claimant was working down in the workshops, and during a rest period when he was changing
10:10his shoes, he sat on a chair, which he alleges collapsed underneath him, which meant he'd fallen
10:15to the floor, tried to pick himself up, fell a second time, and hurt his back.
10:25The claimant, after the accident, was taken down to healthcare, where he received medical
10:31attention.
10:33Initially, the claim seemed one of those that we would be likely to settle.
10:37The chair had collapsed, he'd hurt himself, it just seemed to be a normal claim.
10:43A simple accident, but according to the claimant, the effects had been severe and wide ranging.
10:49He claimed he had hurt his lower back, and several months later he was still suffering from
10:56it and was still on painkillers for it.
10:59The government legal department estimated that the claim could be worth as much as £10,000.
11:06In situations like this, any payouts come from the public purse.
11:10So, it was vital to check the facts, which appeared sketchy.
11:15We started to doubt that the claim was genuine, firstly when we viewed the CCTV footage.
11:22Security cameras are common on the outside and even more so inside prisons.
11:27Little escapes their unblinking gaze.
11:32I expected to see the claimant sitting on the chair and then falling to the floor as he'd stated in
11:37his statement.
11:40On the footage, it shows the claimant actually sitting on the chair.
11:45He spends some time sitting on the chair, approximately 30 seconds, and he actually changes his shoes.
11:51He then turns sideways and leans against the back of the chair, possibly to speak to the gentleman behind him.
11:59And then the chair comes apart and you actually see him slip down maybe two or three inches.
12:07There's barely any movement at all.
12:10He certainly doesn't fall to the floor as he'd stated in his statement.
12:14It's only when he stands up and picks up two pieces of chair that you actually realise that anything very
12:20much has happened.
12:21Chair possibly came apart at the legs, but the fact that the chair only moved a couple of inches and
12:28is a padded chair,
12:29I can't see how anybody could actually injure themselves in that instant.
12:35When I first viewed the footage, I just thought it was basically somebody who was just trying to get some
12:41money out of the system.
12:43There clearly wasn't anything to claim as far as I was concerned.
12:48On top of the video evidence, a request for medical details about the inmate uncovered some very interesting information.
12:55The claimant already had a pre-existing back complaint, which he had prior to coming to this country, so for
13:01several years,
13:02and was still receiving medication for it at the time of this incident.
13:07The claimant had neglected to inform anyone about his pre-existing back problems,
13:12suggesting he was being less than honest about the effects of this minor fall.
13:16His claim was about the current pain that he was suffering and he was alleging it was all due to
13:23the accident,
13:24whereas we were able to show that he was already on medication for a back problem
13:28and therefore it was possible that he had not sustained any injuries at all during this incident.
13:36The Government Legal Department then went back to the claimant's solicitors
13:40and advised them that we would be denying liability.
13:44They wanted to take it forward, so we went to a court hearing in the end.
13:50The inmates' hopes for a payout were dashed in front of the judge.
13:55Under cross-examination by our barrister, the claimant actually admitted
14:00that there were times when he didn't know if the pain he still felt was due to the accident
14:05or his pre-existing medical condition.
14:09The judge viewed the CCTV footage three times and came to the conclusion herself
14:14that he lied within his witness statement and we were awarded costs.
14:20£20,000 that he will have to pay the prison service.
14:25We will fight them. If we don't think they are genuine, we will fight the claims all the way.
14:30A great result and a strong deterrent to any other prisoner
14:34are tempted to chance a fraudulent claim behind bars.
14:39One of our prime focuses in prisons is actually to help people change their lives
14:44and stop them having criminal attitudes and doing criminal things.
14:48So, you know, one of the first ways we can do that is to discourage people
14:51and teach them that fraud and dishonesty doesn't pay.
14:55There's just a principle here of right and wrong and crime shouldn't be rewarded.
15:04Later, dash cam footage reveals all as a stooge is stopped in his tracks.
15:09It's got all the hallmarks of a crash for cash scenario.
15:24Students away from home look forward to new friends and nightlife alongside the hard graft of study.
15:30But protecting the expensive tech they rely on can be a challenge.
15:34With student numbers now reaching nearly 3 million, there are more laptops and phones in circulation than ever.
15:41Unsurprisingly, items get lost or stolen.
15:44And for a cash-strapped student, they're costly to replace.
15:47As TCS claims discovered in this case, students need the right advice.
15:52The customer reported to us that they'd lost their mobile phone on the evening of the 10th of November.
15:58The phone was a smartphone valiant in excess of £800.
16:02What was unusual with this claim was that there was a slight delay in the customer actually reporting the claim.
16:07And we believed this to be his main mobile telephone that he'd be using day to day.
16:12Is there any reason for the delay in making the claim?
16:15I mean, it's not a big delay, we just need to note the claim.
16:19Just trying to sort everything out.
16:21What, sorry, what were you sorting out?
16:24I'd been home.
16:26So I was waiting to get home so I didn't have all the information on the, waiting to come back
16:32to uni.
16:33Okay.
16:34We had a conversation with the customer with regards to the delay.
16:37The customer communicated to us that they were at home at the time of the loss and had to travel
16:42back to their student address in order to obtain the paperwork with the insurance details on.
16:47You can just confirm exactly what's happened to your phone and as much detail as possible.
16:52So I went, well, I'd gone home to see my family and my older brother asked me if I wanted
16:58to go watch the English only game.
17:02So we went into town to the local bar to watch the football and then I got home and I
17:10didn't have my phone on me.
17:13So I contacted the police and they reported on their system if it was lost or stolen.
17:21And I contacted the EE just to say that my phone had been, well, lost or stolen.
17:28As part of our claims investigation, we do look at the policy details and telephone numbers that have been lodged
17:33against the account.
17:34What we noticed during some of these calls was that the number that was actually provided when the policy was
17:39taken out also matched the one that the customer was calling off today, but wasn't the number that actually been
17:45lost.
17:47So did you just have another number or?
17:50Yeah, the uni provided with three pay-as-you-go SIMs, so I had that in my old phone.
17:56And when was the first time that you used your pay-as-you-go SIM in your old phone?
18:01Uh, I don't know.
18:04So what do you actually think happened to the phone?
18:07Uh, I don't know. I don't think I've left it anyway.
18:14I don't see how it would have fallen out of my pocket.
18:16So how do you think your phone went from being in your pocket to not in your pocket anymore?
18:21Probably someone coming and seeing it out and taking it.
18:25Do you think someone stole it from your pocket?
18:28Yeah.
18:29Do you know you said you were using your old phone with a SIM card from Giftgap that your uni
18:34gave you?
18:35Yeah.
18:35Would you normally use this number often?
18:39Not often to call people.
18:41Okay, so it wouldn't be your point of contact or anything if someone was to ask for your number?
18:47No.
18:48No? Okay.
18:49So is everything you've told me today true to the best of your knowledge?
18:53Yep.
18:54And do you still wish to proceed with a claim?
18:57Yep.
18:58If it is unusual for a customer not to log their main telephone number on their policy as their main
19:04point of contact,
19:05you would certainly expect that for any normal insurance policy.
19:09He was claiming for a different phone with a number that wasn't listed on his policy,
19:14which meant questions had to be asked.
19:17So the number of calls you were not, did you say that's the one, that's the Giftgap number?
19:22Yeah.
19:23So I can see you actually, when you took out the policy, when you took it out online,
19:27I can see you actually put this number as your sort of contact number on your policy.
19:31Is there any reason why you could put that number on there if that's not normally the SIM card you
19:35would use?
19:37I don't use it very often, but I want to have one with it.
19:40Okay. Is there any reason why you want to put your normal SIM card number on there, the one with
19:44EE, with the phone that was lost?
19:47No, not really.
19:48What we were trying to ascertain was actually whether the mobile phone in question was the phone that he used
19:53for his main purpose.
19:54So was this the phone that he used on a day-to-day basis?
19:58The policy holder wasn't exactly forthcoming, but one thing did become clear.
20:04From the information provided at this stage, it did indicate that in fact the policy had been taken out after
20:10the incident had occurred.
20:12It does look quite concerning to me at the moment because obviously this policy is quite a new one as
20:17well.
20:18It does look like to me you've actually taken out the policy after the incident's happened and put a different
20:22SIM card number as your contact number.
20:25Would I be right in thinking that?
20:28Yeah.
20:29That is correct. So the incident happened before you took out the policy?
20:34Yeah.
20:34Basically, what happened was we were able to install them and I tried to go through the union insurance.
20:47Yeah.
20:48Well, they said it was only from the property. So my mum said she'd check her house insurance if she
20:56doesn't have a name.
20:57And then take out the insurance and then wipe it and see if she can do anything. If not, then.
21:04Okay.
21:05If I can't do anything, then I can't do anything.
21:08In this case, perhaps mother didn't know best.
21:11Following our investigation, the claim was refudiated in full and the policy was cancelled and voided from inception.
21:18We did have a conversation with the customer at this point as to whether they had any questions regarding the
21:23cancellation of the policy in which the customer did terminate the phone call.
21:27Because the incident did happen before you took out the policy, unfortunately, we're unable to cover this claim.
21:33Also, because you have actually misrepresented your claim, we're going to actually look to void your policy.
21:38And if you do wish to insure your items, you will have to look elsewhere.
21:41And if you do take out insurance in the future, you will have to disclose to them that you have
21:45been refused this insurance, unfortunately.
21:48Okay, so do you have any questions about that at all?
21:56I don't think this particular customer grasped that this was fraud.
22:00I think that it was just an honest mistake and he was just trusting his mother's advice.
22:06Safe to say, I don't think she'll be getting mum of the year any time soon.
22:10No, her son's lost the phone and he won't be able to get cover easily in the future.
22:15As a result of the policy being voided, this is going to have future consequences for the customer.
22:21This will mean now that for any future insurance product, the customer will have to declare that they've had a
22:25policy voided.
22:34Staged road accidents or crash for cash scams are engineered by criminals to force innocent motorists into a collision.
22:42While dangerous, the practice isn't rare.
22:46Industry data suggests one in ten personal injury claims are linked to these scams,
22:51where chances target law-abiding drivers with the sole intention of making a claim.
22:56Admiral has seen it all, and this next case is one of the more elaborate stings.
23:01A classic stooge-induced accident.
23:05Our policy holder, driving down the road, third party in front of them, another car in front of that.
23:12This is the stooge, and it has one job, make a sudden manoeuvre.
23:17Slams on, turns left, our policy holder goes into the back of the third party.
23:23Of course, it's rarely just the gang's car that's damaged.
23:27Admiral received three-person injury claims, a claim for damage to the vehicle,
23:33some storage, recovery, and also a credit hire bill as well.
23:38Altogether, the claims were just short of 19,000.
23:43In these accidents, the car behind is almost always judged to be at fault,
23:47with their insurance expected to pay for the damage.
23:52Motorists must leave enough distance from the car in front and be ready to react.
23:59The third party's version of events was that our policy holder had been driving too close
24:03and had smashed into the back of their vehicle.
24:07It used to be one driver's word against another, and often a quick payout.
24:12But here, there was an expert witness.
24:15When the policy holder reported the accident to us,
24:18we were lucky enough to have dash cam footage in that vehicle,
24:22and he suggested that something odd had happened, and this was an induced accident.
24:31So in the dash cam footage, you can see that before our accident happens,
24:38there's another party that turns off the road to the left-hand side.
24:42There's no exaggerated break-in on the part of the third party.
24:46There's no emergency stop.
24:48The footage shows the team is in place and ready for action.
24:51What happens next is a prime example of an orchestrated crash.
24:56When the stooge vehicle does it, there's a dramatic scene of events,
25:01with him slamming on his brakes, causing our policy holder to run into the rear of his vehicle.
25:06The footage clearly reveals the car at a virtual standstill in front of the policy holder,
25:11with him unable to slow in time.
25:14It certainly wasn't a case of poor driving on the part of our policy holder.
25:19It's got all the hallmarks of a crash for cash scenario.
25:25The gang set up this scenario purely to make a quick buck,
25:28but the dash cam had exposed their dirty work.
25:33There was no doubt that this had been orchestrated,
25:36that the stooge vehicle and the third party were working together,
25:39and we were going to be able to repudiate this claim very quickly,
25:43and we couldn't really see what evidence they were going to be able to present
25:47to say, no, this was bad driving on the part of your policy holder.
25:52We sent it off to the third party solicitors,
25:55and said on no account are we considering any claims from this incident.
26:01They discontinued and closed their files,
26:04and we managed to log our savings in relation to all the money that otherwise we would have paid out.
26:10Crash for Cash cost the insurance industry nearly £400 million each year,
26:15and we all feel the impact.
26:19Insurance fraud isn't a victimless crime.
26:22Ultimately, we're all paying for these people that are committing the fraud,
26:26because our premiums are increasing as a result.
26:32Induced accidents of this nature have got an economic impact on the public,
26:35but they've also got a safety impact as well.
26:38We've had serious personal injuries as a result, and some deaths.
26:42The public need to be very careful if they see something like this happening.
26:47The increasing use of dashcams is making a difference.
26:51A third of drivers now have them.
26:55If all cars were fitted with dashcams,
26:57it would certainly be easier to fight a lot of the insurance fraud that we see.
27:01Not all of it, but certainly most of it would disappear if we had video evidence.
27:13Still to come, a fraudster plays for high stakes with forged documents.
27:19This is quite a sophisticated, well-planned fraud for a holiday to Las Vegas.
27:25Two adults, two children, a value claim of £16,732.
27:44We spend a lot of time and money making our houses homely,
27:48but rooms and their contents can take a real hammering,
27:51from playing children to pets padding about.
27:54Insurance is there to help replace things when accidents happen,
27:57but some see a policy as a way to claim for items that simply aren't covered.
28:03ICOG handles claims for insurers across the UK,
28:06and has a great deal of experience with both household items and stroppy customers.
28:11The policyholder was claiming for a rip in his leather settee caused by his daughters had been caught in it,
28:19and it was worth about £400 to £450.
28:24The policyholder's daughter had been on the settee and was wearing a jacket,
28:30and that somehow got caught in the stitching of the settee and it had become ripped.
28:37Household insurance doesn't cover simple wear and tear, so this had to be ruled out.
28:42But from the start, there wasn't much to go on.
28:47There was little evidence supplied by the claimants,
28:50and due to the age of the settee there were no receipts.
28:53However, there was the original conversation and also our inspection report.
28:59The photos taken at the inspector's visit raised doubts for Liz and her team.
29:04Leather settees are quite robust, so I wasn't expecting to see a massive amount of damage to the settee.
29:12Photographs showed a settee that had probably been bounced and jumped all over by children.
29:18It was stained, it just generally didn't look in good condition that he was insisting it was.
29:26I didn't think it plausible that a child's jacket could have caused that amount of damage.
29:31And there was another question mark.
29:35The policyholder had made a previous claim, damage to a settee,
29:41and it was the other half of the set that this one was part of as well.
29:46That claim had been settled by the insurance company a couple of years ago.
29:51But I did think that there was some significance in the fact that he now had one half of his
29:56settee be brand new,
29:58because it had been replaced, and the other half was an 80-year-old battered model.
30:06Despite the case being of a relatively low value, I think once we had the inspection report,
30:13and we'd seen the photographic evidence of the damage,
30:15it was clear that we had to ask some more questions to how the accidental damage had actually happened.
30:22There's just one or two sort of questions that have been raised from the report,
30:25which I just wanted to have a chat with you about.
30:28OK.
30:29OK.
30:30Can you just give me an outline as to how the damage occurred?
30:55OK.
30:56It was strange that we were speaking to the husband, purely in sympathy,
30:59because it was his wife who was in the room at the time it had happened,
31:03and he wasn't there and didn't see what had happened.
31:06One thing I wanted to chat about is because, obviously,
31:09leather soap is normally doubled or sort of triple-stitched on the seating area,
31:15and I'm just trying to work out how the zip managed to get caught.
31:20Well, I wasn't there with an accident. I don't know how he got caught.
31:25Maybe if I did it in our authority, but as far as there's an accident.
31:28Mm-hm, mm-hm.
31:31We tried from every angle to ask him questions about what may have happened,
31:35how it could have happened, but he stonewalled and just said,
31:38I wasn't there, I didn't see what happened.
31:40As the jacket was pulled out, is it at that point that the stitching went?
31:51Yes, yes.
31:52OK, thank you.
31:53I appreciate this, I appreciate how frustrating this is, and hopefully...
31:58Well, yeah, I just feel like I've been interrogated for something, you know,
32:02that's criminal.
32:03I've told you, you've asked me exactly the same question you asked me again.
32:06Are you trying to catch me out of something? I don't know.
32:08No, not at all.
32:09And if you don't know the answers, I'm quite happy for you.
32:12I've told you my answer. I've told you.
32:14It was, you know, my daughter, I don't know what happened.
32:16She must have been, there was an accident.
32:18She got us the caught in the jacket and the ribs.
32:20I'm just trying to find out how, you know, a zip would have got caught.
32:23Well, I've told you that.
32:24Do you have any other questions? I've answered you.
32:26OK.
32:28He doesn't sound happy.
32:30In fact, he's becoming increasingly agitated.
32:33This did heighten suspicions.
32:35His wife was in the background when he was on the phone to me.
32:38That was quite obvious.
32:39And he could easily have asked her some of the questions that I was asking him.
32:45But he didn't.
32:48Your wife had been asked to make sure that you kept hold of all the damaged items.
32:53I'm looking at the report that's been sent back.
32:56And that report just states that the jacket that was involved in the incident wasn't available.
33:02But they've taken a picture of one that was similar.
33:04Goodness me. I don't know what you guys are talking about.
33:16It's fair to say he adopted a rather defensive attitude, but the facts simply weren't stacking up.
33:21The photograph of the jacket, he insisted, was the original jacket involved in the incident.
33:30The one thing that hasn't shown up on the picture of the jacket was any damage done to that?
33:37Any damage? There wasn't any damage done to the jacket, it was the zip.
33:40So what damage happened to the zip?
33:42I said, what kind of damage did you expect to see from the zip?
33:45The zip is strong.
33:46He pulled his zip and he ripped the chair.
33:48I didn't say I wasn't claiming for the zip or for the jacket.
33:52Okay.
33:54During the phone call, the ponceholder became more and more agitated.
33:58And it was very much a case of, I've paid my premiums.
34:02You should be paying me out for this claim.
34:05The accident happened. It was an accident.
34:08Do you think it actually deliberately ripped itself off?
34:11I, well, I've made an opinion, to be honest.
34:14I was just asking you some questions about that.
34:17The policyholder wasn't happy.
34:19He just said, right, you either pay him a claim or you don't.
34:23Do whatever you have to do.
34:26And that was basically how he ended the phone call.
34:30You can at this stage still withdraw your claim, which means that you...
34:33Why, why, why, why would he be suggesting why should I withdraw it?
34:36Why?
34:38Don't say I'm sorry, don't ask me that.
34:40I think you're enforcing me.
34:41Do not even ask me that.
34:42Please do not insult me by asking me stupid questions, please.
34:45Given a clear lack of evidence and an unforthcoming policyholder,
34:49there was only one way this could go.
34:52Had it been accidental damage?
34:54Caused by that jacket?
34:56Yes, it would have been covered.
34:58But there was no account or evidence to show that it would have been accidental damage caused by that jacket.
35:09We passed our report back to the insurer and they followed through with our recommendation and declined to pay for
35:16the damage.
35:18The fact that this was a low value claim, to me, is almost irrelevant.
35:24Insurance companies shouldn't be paying.
35:42Fraudsters, scammers and opportunists are often happy to take a gamble for a bit of free cash.
35:49But it's a high stakes game where they run the risk of facing the full force of the law, with
35:54many now trading that gamble for a sell in a British prison.
36:00Direct Line Group handles thousands of claims each year.
36:03And Mike Brown, who heads up its counter-fraud unit, recalls a case that demonstrates the extreme lengths some fraudsters
36:10will go to.
36:14This claim is a travel claim, and the circumstances are that the claimant, who in fact he himself is a
36:24director of a tour operating company, booked a short holiday to Las Vegas for himself, his partner and two children.
36:34The holiday was booked online, and a deposit of £700 was paid.
36:42It sounded like a dream trip, a belated honeymoon and family getaway, with the Bellagio thrown in for extra glamour.
36:50Clearly, going to Vegas and staying at one of the premier hotels is going to be expensive.
36:56The shows, the gambling, the restaurants, fantastic holiday, but will be expensive.
37:00And even more costly than the claimant thought, as a family emergency meant he had to cancel his trip.
37:09Monday last week, my mother-in-law was rushed to hospital.
37:14OK.
37:14We were due to go to Las Vegas for our honeymoon in mid-last week.
37:19But I didn't go, obviously, because of the situation.
37:24I'm not sure, you know, what any next steps are, if obviously I can't commence a claim and take it
37:30from there, really.
37:33At this point, the claimant thought they were playing a bit of a wild card, but as luck would have
37:39it...
37:41Based on the policy wording, we can consider a claim on the grounds of a close family relative being ill
37:47anyway, so...
37:50Now, the holiday itself, was it booked fights and accommodation separately, or was it an all-in-one?
37:55No, it was an all-in-one.
37:57And how much was it, then, please?
37:58I think it was just shy of 10,000 off the top of my head.
38:03Yeah, it was about 10,000, I think.
38:05Oh, dear.
38:06You should never say and do after canceling it.
38:09Yeah.
38:09It's not ideal, but hopefully...
38:13No worries.
38:14Well, I'll put 10,000 down as an approximate figure.
38:17Well, I'll put a promise by it, so that way, if it needs to be adjusted up or down, it
38:22can do.
38:22The limits on the policy is £5,000 per insured person.
38:28Yeah.
38:29And that includes your two children as well.
38:32So, you're well within the £20,000.
38:35The claimant wouldn't be out of pocket.
38:39The claimant were also asked to provide supporting documentation,
38:43cancellation notice, medical documentation in support of the ailment, all of which were sent in.
38:52The family holiday was worth more than the claimant said.
38:56The invoice that was submitted in support of the claim was for a holiday to Las Vegas.
39:03Two adults, two children.
39:05The value of the holiday claim was £16,732.
39:09The invoice, in fact, highlighted that the holiday had been paid in full.
39:15So, given the sad circumstances, the supporting paperwork and a desire to compensate its customer...
39:23A cheque was raised for £16,700 and it was posted out to you.
39:30But less than 24 hours later, a final look over his paperwork suddenly put the whole claim into doubt.
39:38And Mike's team immediately contacted him.
39:41I can see that a cheque was sent out, but the cheque was sent out in error.
39:47So, we said advise you not to cash that cheque as you may be charged by the bank as to
39:52a stop cheque has been sent through.
39:54And, yeah, so we're still currently looking at the claim.
39:57OK.
39:58Right, OK.
39:58I think we need a clarification on some of the invoices.
40:03All right, OK.
40:04And then, yeah, we'll contact you soon and then update you.
40:07OK.
40:07All right, thank you.
40:09But the very next day...
40:11The claimant clearly seized an opportunity to make hay and cast the cheque.
40:19Not quite the actions of an honest customer.
40:22And something else had raised suspicions.
40:24There were concerns around the cancellation notice.
40:28We then made inquiries with the tour operator who confirmed that the cancellation notice related to another holiday that had
40:38been booked earlier that year.
40:41Exhibit A, destination Las Vegas for four people.
40:46But all of them adults, not a family holiday.
40:49And a £700 deposit had been paid.
40:53However...
40:55Despite being sent repeated reminders, the pilot tour operator failed to pay the remaining outstanding balance.
41:03And the holiday was cancelled.
41:05And a cancellation notice was served.
41:08It appeared the chips were down for the claimant.
41:11With two holidays that hadn't gone ahead.
41:14I think the important thing for him was to secure a legitimate cancellation document
41:21for which he would then use as a template to successfully make his fraudulent claim.
41:29Using Exhibit A from the cancelled trip for four adults, the claimant could now create Exhibit B, a forged document
41:37for a family trip to Las Vegas.
41:38This has been a very cleverly planned fraudulent insurance claim.
41:46The claimants had originally booked a holiday with a leading tour operator.
41:52There's no doubt that that was the motivator to get the original documents.
41:57Having secured the documentation, he then books a further holiday using a local tour operator.
42:08That tour operator was, in fact, the claimant's own travel company.
42:14And it's that documentation he produces to Direct Line Group in respect to the holiday in Las Vegas.
42:22This was actually a bogus trip consisting of a fictional booking and a fake invoice.
42:29Effectively, the claimant paid £700 to get bona fide documents he could then forge to put in a claim for
42:36more than £16,000.
42:38A sizeable return on his £700 investment.
42:44From the outset, this is quite a sophisticated and well-planned fraud.
42:48The original invoice was for four adults and his policy would only be covered for him.
42:54So he creates a bogus holiday for the family.
42:57He needed to ensure that his travel policy met all the terms and conditions.
43:03And his current policy covered him, his partner and family members, i.e. two children.
43:09Allowing him to get a royal flush.
43:13Direct Line Group decided it was time for a little less conversation and a little more action.
43:19It called the police.
43:20At this point in the investigation, we were clearly satisfied that there was sufficient evidence
43:27to secure criminal proceedings against Mr. Dillon.
43:31Police then discovered it wasn't just Direct Line Group he tried to swindle.
43:35He had used his travel agency to steal from customers.
43:40Money for several flights was deposited in an account they believed to be the parent travel company.
43:47It was, in fact, the claimant's personal one.
43:51He pockets £38,000.
43:53A local college paid him £10,000 for a trip to Poland that never materialised.
43:58And he stole £5,000 from a trusting employee.
44:02For a Florida getaway he didn't book.
44:06In total, the claimant defrauded these innocent people of more than £50,000.
44:12He was formally charged with four offences of fraud under the Fraud Act 2006.
44:19He pleaded guilty on all counts.
44:23And at his local Crown Court, the claimant was sentenced, ending up behind bars for eight months.
44:33Direct Line Group is extremely happy with the sentence.
44:36Insurance fraud is not victimless.
44:38And the sentence imposed should serve as a stark warning for those that seek to commit insurance fraud in the
44:46future.
44:46The bed.
44:49A
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