A woman has been sentenced to two years in prison for making dozens of fake medical claims, including in the aftermath of the terrorist attack that struck Manchester Arena last year.
Susan Pain pleaded guilty to fraud by false representation at Liverpool Crown Court, following a City of London Police’s Insurance Fraud Enforcement Department (IFED) investigation into a series of fake claims made in the names of aliases, friends and family.
Pain worked as a director for an insurance broker, whose policies were underwritten by AXA, and oversaw a section covering the medical and dental professions against unexpected overheads.
AXA discovered that Pain had processed a claim in her own name—as she was known professionally as Susan Raufer—for loss of earnings due to her daughter sustaining multiple serious injuries in the terror attack at Manchester Arena, and having to undergo two major operations.
In reality, Pain had no children and AXA soon found out that the claim was false as the insurer was unable to trace the victim. After this, AXA conducted a complete review of the claims processed by Pain and discovered a number of other discrepancies.
Between March 2010 and July 2017, Pain made a total of 31 fraudulent insurance claims in the names of friends and family, plus some in her own name.
In one of the claims, Pain posed as an orthodontist who had taken a leave of absence because their daughter required open heart surgery and the hospital was far away from their home.
In several other claims, she also used various types of cancer as the medical condition that the family member of the medical professional had suffered.
Most of the claims were for loss of earnings because someone related to the medical or dental professional had become seriously ill or was injured, but there were also claims for Jury Service and maternity leave.
In total, Pain falsely claimed £142,334. To launder the money, she asked her friends and family, whose names she’d used to make the claims, to receive the money into their bank accounts through cheques and BACS transfer.
Detective constable Ant Andrews, who the led the investigation for IFED, said: “Pain exploited the tragic terror attack at the MEN Arena, as well as other examples of human suffering, to make a financial gain.”
“She betrayed the trust she had with her friends and family, using their details to make the false claims, then lying to them so she could receive the money she’d stolen.”
“She is now paying a significant price for her fraudulent activity, not just with the sentence handed down by the court, but also with the loss of her job and reputation.”
Carolyn Scott, head of household and lifestyle at AXA Insurance, commented: “Ms Pain took advantage of a position of trust to deceive her employer and defraud AXA. She used details of extremely upsetting events and circumstances to make fraudulent claims for her own personal gain. We alerted IFED once we suspected fraudulent activity and are very happy with the outcome today. Cases like this prove that collaboration can ensure fraudsters are brought to justice.”