“It’s All In The Details” – An Insurance Fraud Case Study.

We received instruction from a UK insurance company who wanted a secondary investigation completed to support the one completed by their own claims management team in relation to an insurance claim made by one of their policyholders.

The policyholder had submitted a claim that his BMW 1 Series vehicle had been stolen at the end of March 2018. The initial contact centre staff member taking the details raised a concern and the claims management team put one of their investigators on it.

The investigator came back and notified the company that there was “nothing” suspicious about the claim, that they found the policyholder to be “entirely believable” and that they had “no concerns”. The insurance company weren’t convinced – the policyholder couldn’t locate his V5, his crime reference number for reporting it did not appear valid and he allegedly changed the location of where he said it was last parked once it was pointed out to him that there was heavy CCTV coverage in that area.

What’s more, within only two weeks of submitting his claim the policyholder had raised a formal complaint against the insurance company for not concluding and paying out at speed – almost suggesting he wanted this all wrapped up and boxed away without too many questions being asked or too much scrutiny being applied.

Surmount Investigations were asked to re-interview the policyholder, review the case file and apply independent consideration whilst also working in a field agent capacity to gather further required evidence to submit back to the claims management team handling this claim.

The policyholder did not keep to the appointment he had with us to meet and be re-interviewed. Nor did he keep to the re-scheduled appointment. Or the third appointment scheduled after that. Which obviously wasn’t suspicious in the least…

We went down to the policyholder’s property and carried out a walk-around of the estate and made some localised enquiries then reviewed the paperwork submitted originally by the policyholder for his stolen car claim. It was within this paperwork that we noticed the policyholder had listed a friend who lived in Monkseaton as being with him at the time of the car being stolen “and could confirm it was all locked up properly and alarmed”. This friend was then marked as “unavailable to speak to” by the policyholder.

So we took a trip down to Monkseaton and checked out the address of the policyholder’s friend. There in a tiny side street behind the friend’s address was a BMW 1 Series parked up out of sight. The registration matched the policyholder’s. The car was in clear and pristine condition. And when we approached it there was documentation like utility bills on display on the passenger seat.

We took some close up shots of the utility bills, getting evidence of the fact that not only were they in the policyholder’s name and address but that they were dated within the last 14 days. We took some time and date stamped photographs of the vehicles location and covertly placed some sticker markers on the underside of the tires. We then informed our clients of what we’d discovered.

Our suggestion was to immediately inform the policyholder that his vehicle had been found in Monkseaton whilst we held the vehicle itself under observation and to see what played out: Sure enough, within two hours of the insurance company doing so, a male exited the address in Monkseaton, got in the car and moved off down to Wallsend… where he handed the car back off to the policyholder himself – who in turn moved it on to a garage lock-up in the West End of Newcastle.

All of which was covertly observed and filmed by the Surmount Investigations team.

A full and extensive report with evidence was submitted back to the insurance company who voided the policy and subsequently notified the police.