Sunday, December 14, 2008

Insurance fraudsters? We shall sight them from the bushes

The world's most exciting insurance job is also a booming area of business. Under cover of foliage, Paul Kendall joins the intrepid claim investigators.

By Paul Kendall
Last Updated: 12:53AM GMT 14 Dec 2008

It is just after six on a bitter December morning and I am lying in the mud on a strip of scrubland next to a bush. All is quiet, save for a handful of reeds whistling in the breeze. Suddenly, out of the gloom, the bush speaks. "Sierra, this is Hotel," it says. "We are in position."

A video camera appears from within the vegetation and points towards a handsome, whitewashed house 200 yards away. "Dwelling is in darkness," says the bush. "No sign of subject."

Then, silence again. "Hotel" – not actually a bush, but a burly former member of the Special Forces – squats next to me, dressed head to foot in camouflage gear, not moving. The minutes tick by. It starts to rain. As the early-morning sky turns slowly from dark blue to a pale, frosty white, we continue to scan the house for any signs of life.

"You know," my companion whispers eventually, "people don't realise the lengths you have to go to in this job. No one sees that."

Hotel is an insurance fraud investigator, a specialist in "static control", which means he spends his working life hiding in trees, undergrowth and ditches, spying on people who claim to be injured and unable to work.

In his time, he has caught out hundreds of fraudsters: men who had said they couldn't walk playing a round of golf; enthusiastic ramblers who had claimed they were confined to a wheelchair; even workers blinded in an accident who could miraculously drive a car. He investigates an average of two or three cases a week, and thanks to the current recession, he has never been busier.

For, while other employers are laying off staff, the fraud investigation business is booming as companies look to cut down on the vast amounts they pay out in personal injury claims. Local authorities that are sued by people who have tripped over broken pavements or potholes are also good customers.

Business is so buoyant, in fact, that Hotel's employer, the surveillance firm CIA Excel, is advertising for recruits for the first time in its 19-year history. More than 300 people have applied for the two available posts, 15 of whom will attend a series of intense military-style boot camps, where they will be assessed in nine areas, including observation, driving skills and their ability to react under pressure. Anyone who thinks insurance is a dull, desk-bound job needs to think again.

"This is one of the most challenging civilian jobs you could do," says Alan D'Ambrosio, CIA Excel's managing director, when I speak to him on the phone from his home in Scotland. "Operators have to be prepared to work long and irregular hours in unfamiliar and often dangerous environments. It is an extremely tough job, and those applicants who are successful will need to be both extraordinarily patient and, at the same time, very quick-witted."

Investigators also need to look "grey" – in other words, they must have the kind of face that blends into a crowd. Both Hotel and his partner, Sierra, a former policeman and one of the most unprepossessing men I have ever met, score perfectly on all fronts.

At 7.48am, after a display of stillness that puts me in mind of a Buddhist monk, Hotel snaps into action. A light has come on in the "target" property. The subject, a businessman in his late 40s who is suing a motor insurance company after sustaining back and neck injuries in a motorbike accident, has appeared in his dressing gown in the kitchen. The fact that Hotel has spotted the subject at all impresses me. I'm also dressed in camouflage, but can't see anything through all the foliage.

"Sierra, this is Hotel. Light on in property. Repeat, light on in property," he says, talking into a two-way radio.

"Is there?" I whisper, "Where?" Too late, I realise I'm talking to a mound of grass. Hotel has moved to some higher ground 30 yards to my right to gain a better view. I curse and desperately rearrange my headpiece.

Ten minutes later, foliage out of the way, I glimpse our man outside his house. He has told doctors he can hardly walk, but despite this, he pushes a wheelie bin up the drive, through a gate and out on to the street.

Hotel whips out his camcorder again. "Subject is pushing a wheelie bin and showing no signs of discomfort," he says into the microphone. Then, turning to me: "OK, move out."

Together – in the sort of manoeuvre that would convince Macbeth that Birnam Wood had moved to Dunsinane – we scurry across the scrubland towards the shelter of some trees. Once there, we remove our bush suits, place them in rucksacks and, when the coast is clear, jump over a fence and walk along the road back to Hotel's car. This, I am told, marks the second phase of the operation.

The man we are watching has said he cannot drive, but 'local intelligence' has assured Hotel and Sierra, who is parked down the road in a surveillance van, that he can. Sure enough, before long he pulls out of his driveway in a silver 4 x 4.

"Stand by, stand by, stand by," says Hotel. "That's the subject's vehicle in your direction. We're in pursuit."

Weaving in and out of traffic, the two investigators take it in turns to tail the man. In the event, he drives only as far as the local petrol station before returning home. It's not enough to prove he is faking.

But 20 minutes later, he is off again. And this time he drives much farther, first to the local school, where he drops off his daughter, then to a café, where he has a coffee and reads the paper, and then to a secondary school in a neighbouring village.

While we wait outside the school for the man to reappear, Hotel tells me about a recent case. It is obvious that he takes great pride in what he does. "Last year, we investigated a man who was claiming a quarter of a million pounds a year for care," he says. "He had lost half a leg in an industrial accident, which entitled him to some compensation, obviously, but he was claiming for four carers and grossly exaggerating his disability."

Hotel watched him 12 hours a day for seven days, mostly from an observation point in a canal, using a pair of high-powered binoculars. "It was one of the most difficult surveillance jobs I've ever done. But we established that the subject was more or less independent. He could walk on his own, cook on his own, and go to the lavatory on his own – all things he'd said were impossible."

The evidence collected by the investigators is expected to reduce the subject's claim by at least £200,000 a year.

And that was just one of more than 1,000 cases that CIA Excel investigated last year. Altogether, D'Ambrosio says he saves his clients tens of millions of pounds. I wonder, however, whether Hotel ever feels uncomfortable about snooping on people.

"Why should I?" he says. "I mean, it's you and me who pay for these people through higher premiums. We are staying within the law and trying to do a difficult job, while these people break the law and try to get money by deception. We are here to make sure that everyone pays a fair price for insurance."

As he says this, the man we have been following reappears in his silver 4 x 4, with his older daughter in the passenger seat. This time he sets off on a 35-mile journey to a dental surgery. He parks and gets
out the car. It is about 100 yards to the door of the surgery, over frosty ground, but he covers the distance with consummate ease.

"There he is! There he is!" exclaims Hotel, as we watch from a safe distance. "He's walking!" Everything is recorded on video. "OK, job done," says Hotel. "Let's get breakfast." There is an unmistakable note of glee in his voice.