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Advice Only for Greater Anglia - Delay Repay Fraud

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ashkeba

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How do you think insurance fraud is investigated? You’d think the first claim I was paid would be paid to me in good faith, but after five or six in a year, the insurers might start asking questions, no? And you don’t think insurers investigate fraud that might have happened a year or two ago? How do you think all that stuff works?
I do not understand what this is to do with a supermarket age check for buying beer.

I also think most people would keep evidence for an insurance claim for much longer than a delayed train claim. Probably the usual seven years for home financial records. I think just my insurance excess is more than I have claimed in Delay Repay in ten years. Delayed trains are much more common than insirance claims. It is all about proportionate.
 
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simonw

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I do not understand what this is to do with a supermarket age check for buying beer.

I also think I would keep evidence for an insurance claim for much longer than a delayed train claim. Probably the usual seven years for home financial records. I think just my insurance excess is more than I have claimed in Delay Repay in ten years.
But we aren't talking here about people who have claimed small amounts like you appear to have claimed.
 

ashkeba

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But we aren't talking here about people who have claimed small amounts like you appear to have claimed.
Only because my commute was two or three stops and has not happened for a year! I bet most of the claims were medium or low value and it was mainly that some people had a lot of claims during the 90s fading away and the Flirt signalling problems. Who would keep detailed evidence for why they used each train over a year later?
 

simonw

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Only because my commute was two or three stops and has not happened for a year! I bet most of the claims were medium or low value and it was mainly that some people had a lot of claims during the 90s fading away and the Flirt signalling problems. Who would keep detailed evidence for why they used each train over a year later?
We do not know this. It is mere supposition. As I said above, the different conclusions people are drawing from very limited information is amazing.
 

AlterEgo

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We do not know this. It is mere supposition. As I said above, the different conclusions people are drawing from very limited information is amazing.
One of the things we should safely assume is that Greater Anglia aren’t naive enough to disclose all their evidence to the customers they suspect of fraud. So, we can only go on conjecture, but I think, having worked in this area, many of the claimants satisfy multiple risk factors: a large number of claims, often at irregular times and often with an overlap with other punters also falling under suspicion. After all, we can all look up the most delayed train from Ipswich to London today, and submit a claim, but do that too many times and you might find a raised eyebrow or two within the claims team.
But as you rightly say, this is conjecture, and the only useful advice we can give is:
If you made false claims, engage with the company and settle.
If you didn’t, say so! Tell them.

Only because my commute was two or three stops and has not happened for a year! I bet most of the claims were medium or low value and it was mainly that some people had a lot of claims during the 90s fading away and the Flirt signalling problems. Who would keep detailed evidence for why they used each train over a year later?
Nobody is asking for evidence. Greater Anglia aren’t - just an explanation. People here have (somewhat naively) suggested to posters to “find some evidence” of their whereabouts, because one thing we can probably suggest links many of the claims is that they just so happened to be on the most delayed train on their route quite a lot of the time.

We all know that we probably can’t remember or even evidence where we were on December 11th 2019, but that doesn’t make it an unfair question to ask.

Again, to those who don’t like GA’s tactics, how would you feel if they just passed the matter onto the police without engaging with customers first?
 

BusterEdwards

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Something that I think should be mentioned here to take things right back to first principals is "What is Fraud"? Fraud can only occur where someone acts dishonestly, with the intent of making a gain for themselves or another, or with the intent of causing a loss or a risk or a loss to another. In the context of fraud "dishonesty" is something that you can never achieve by accident (and not even if the accident might have been quite careless). You can only commit fraud if you decide one day that you are going to do something wrong.

Where someone whose train was cancelled claims the amount of money they are due (or believe to have been due), but under the wrong heading or to the wrong department, they could never conceivably commit fraud and GA know that well.

If Greater Anglia want to start a money claim saying that someone owes them money because they claimed from the wrong department then it's open for them to do so and they can try to prove it on balance of probability, but I can't imagine a court humouring a case where at the time there was a valid set off against other money also due from GA.

In those circumstances I'd tell GA to take a hike, and not particularly politely.
After explaining that I had unwittingly (wrongly) claimed delay repay for an “abandoned journey” .....total of 4 journeys over the last 15 months totalling £35 in paid out compensation I was informed that the delay repay dept is separate from customer services and that ignorance of the law is no excuse blah blah and that the compensation claims were still fraudulent and “how would I like to continue ?”...long story short I work in the city and can’t risk a blot on my copybook and so settled for a total sum less than £100.
Maybe I watch too many court room dramas on TV but would you risk your career on a moot point of train bye laws?GA obviously think not
 

Wolfie

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After explaining that I had unwittingly (wrongly) claimed delay repay for an “abandoned journey” .....total of 4 journeys over the last 15 months totalling £35 in paid out compensation I was informed that the delay repay dept is separate from customer services and that ignorance of the law is no excuse blah blah and that the compensation claims were still fraudulent and “how would I like to continue ?”...long story short I work in the city and can’t risk a blot on my copybook and so settled for a total sum less than £100.
Maybe I watch too many court room dramas on TV but would you risk your career on a moot point of train bye laws?GA obviously think not
I hope going forward that you claim every penny for any delay even 1 minute over the minimum. Document your claims so that they can't pull the same stunt again. Don't get
mad, get even. The admin cost alone will hurt them. If you really want to get petty sue them for the cancelled tickets through MCOL and ensure that any hearing is convenient for you. Their Mickey Mouse rules don't supercede consumer legislation and they won't be able to claim back their legal costs if you use the small claims channel....
 

AlterEgo

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After explaining that I had unwittingly (wrongly) claimed delay repay for an “abandoned journey” .....total of 4 journeys over the last 15 months totalling £35 in paid out compensation I was informed that the delay repay dept is separate from customer services and that ignorance of the law is no excuse blah blah and that the compensation claims were still fraudulent and “how would I like to continue ?”...long story short I work in the city and can’t risk a blot on my copybook and so settled for a total sum less than £100.
Maybe I watch too many court room dramas on TV but would you risk your career on a moot point of train bye laws?GA obviously think not
Ignorance of how to claim properly most certainly *would* be a valid defence to an allegation of fraud, which is a tort (and hence the prosecution would need to prove a “guilty mind”). You also need to benefit from the action, which claiming DR as opposed to abandoned journey probably wouldn’t be. These are not “train bylaws”, this is the Fraud Act 2006.
 

robbeech

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Ignorance of how to claim properly most certainly *would* be a valid defence to an allegation of fraud, which is a tort (and hence the prosecution would need to prove a “guilty mind”). You also need to benefit from the action, which claiming DR as opposed to abandoned journey probably wouldn’t be. These are not “train bylaws”, this is the Fraud Act 2006.
But they've still had to pay back the money they claimed AND additional fees. You agree they aren't a fraud, but GA said they are, and they've settled this out of court. Had they refused to settle out of court GA may have taken them to court, for fraud.
 

Tazi Hupefi

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But they've still had to pay back the money they claimed AND additional fees. You agree they aren't a fraud, but GA said they are, and they've settled this out of court. Had they refused to settle out of court GA may have taken them to court, for fraud.
GA have explicitly advised that they'd hand over to the police for further investigation. There has been no talk of any prosecutions at all from GA. That seems a fair safeguard to have in place, as it allows a secondary investigation, notionally independent, and then a third opinion, from the CPS if necessary, and then a 4th or 5th depending on if it gets to court, and which type of court.

Someone innocent has so many safeguards;

1) GA investigates (not independent but they know they have to remain pragmatic, otherwise the police won't be interested and professional reputational issues).
2) Police investigate
3) CPS review and authorise charge (or not)
4) Magistrates / HMCTS review at case management
5) Either conviction by Magistrates, District Judge or Jury
6) Another judge on appeal

Anyone definitely and obviously innocent is not likely to get past stage 3. CPS are notoriously picky.
 
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robbeech

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I hope going forward that you claim every penny for any delay even 1 minute over the minimum. Document your claims so that they can't pull the same stunt again. Don't get
mad, get even. The admin cost alone will hurt them. If you really want to get petty sue them for the cancelled tickets through MCOL and ensure that any hearing is convenient for you. Their Mickey Mouse rules don't supercede consumer legislation and they won't be able to claim back their legal costs if you use the small claims channel....
I suspect it is more likely they'll never risk claiming again.

GA have explicitly advised that they'd hand over to the police for further investigation. There has been no talk of any prosecutions at all from GA.
I don't think the end result is much different though is it?

GA taking them to court for Fraud, or the police investigating it? The fact remains that if either of them take matter this far then they'll not stand a chance in court and would end up with a much more serious penalty.
 

AlterEgo

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But they've still had to pay back the money they claimed AND additional fees. You agree they aren't a fraud, but GA said they are, and they've settled this out of court. Had they refused to settle out of court GA may have taken them to court, for fraud.
No, GA cannot procedure a fraud and they’d have - maybe - passed the case to the police, who would certainly not have proceeded with a case of that laughable weakness. There’s no reasonable suspicion of fraud there. No benefit, no guilty mind and no suspicion of either.
I’m not defending GA there; that’s bad. The OP should have told them to swivel. Will they get their abandoned journey refund? Probably not. (And it will merely total a 1hr delay under DR anyway!)
 

Tazi Hupefi

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I suspect it is more likely they'll never risk claiming again.


I don't think the end result is much different though is it?

GA taking them to court for Fraud, or the police investigating it? The fact remains that if either of them take matter this far then they'll not stand a chance in court and would end up with a much more serious penalty.
I think it is significantly different. If both GA and the police both independently conclude that there is a case to answer, that would indicate there is at least a reasonable prospect of fraud having been committed. Not that fraud definitely has been committed, but 2 investigations reaching the same conclusion of the potential.
 

robbeech

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I think it is significantly different. If both GA and the police both independently conclude that there is a case to answer, that would indicate there is at least a reasonable prospect of fraud having been committed. Not that fraud definitely has been committed, but 2 investigations reaching the same conclusion of the potential.
As with all of these things, there's an initial bias for all involved. If GA say to the police, this person has claimed a lot, they haven't provided evidence of them getting on and off that train 2 years ago and we think they might be fraudulent, then are the police going to say WE WILL BE THE JUDGE OF THAT, and approach it with an open mind, or are they going to use the "balance of probabilities" that people like to mention and say "yes you're probably right but we need some evidence"?

What is evidence? CCTV of them getting a different train? CCTV of them not being on that train? The fact that more often than not they get the 1600 not the 1700? The fact they tapped in at 1654 and claimed for the 1600 because they saw it was cancelled so went to the pub? That last one would almost certainly flag up the F word.

Combine an above average claim rate (which is a farce in itself) with different travel times, add in a slice of not tapping in because what is the point until the train comes and you've got yourself a guilty verdict and there are examples of that on this forum for similar sorts of things.
 

gingerheid

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Honestly I think there's a stronger argument that GA committed fraud there :( They're the people that have managed to gain money they weren't entitled to, by suggesting someone committed fraud when it appears more likely that they didn't :(
 

robbeech

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Honestly I think there's a stronger argument that GA committed fraud there :( They're the people that have managed to gain money they weren't entitled to, by suggesting someone committed fraud when it appears more likely that they didn't :(
This topic has shown that quite a number of people (almost all although i appreciate it may not be an accurate representation overall) have claimed incorrectly, be that deliberately or using incorrect methods or by selecting the wrong train or whatever else.
 

gingerheid

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This topic has shown that quite a number of people (almost all although i appreciate it may not be an accurate representation overall) have claimed incorrectly, be that deliberately or using incorrect methods or by selecting the wrong train or whatever else.

It absolutely has.

But in this particular case it has also shown that GA have obtained a repayment of money that it appears the customer was entitled to.
 

AlterEgo

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It absolutely has.

But in this particular case it has also shown that GA have obtained a repayment of money that it appears the customer was entitled to.
But you are alleging fraud and dishonesty on the part of GA when there is no evidence of that either.
 

43096

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It absolutely has.

But in this particular case it has also shown that GA have obtained a repayment of money that it appears the customer was entitled to.
You might say GA have fraudulently obtained a repayment of money. What's the phrase: demanding money with menaces?
 

Skie

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Say you made 100 legitimate claims (you were delayed 100 times), but managed to mix up 2 or 3 so that the dates were transposed with days you didn't travel or a delay didn't occur. GA identify those as suspicious claims, and then send a letter out saying they have detected a suspicious pattern from you for some of your claims. Pay up the full amount of the 100 or we'll report you to the fraud squad. They don't say what claims, they don't say how many, just that 'some' of your 'more than average' claims look suspicious and you give everything back, plus a fee, to make this go away.

You don't seem to have the option to fix the incorrect claims (past the cut-off period, too) or have any way to get more details, and as the claims were accepted you have no real evidence saved from that far back. It's a shake-down.

And if it went to court, it could easily go against you. GA can prove 2 of your claims are fraudulent, which casts doubt on the others. You've claimed more than the 'average' GA commuter and you have no evidence of your journeys. A good lawyer might be able to argue that 2 out of 100 is a fairly acceptable error ratio for a data entry task, or that it isn't reasonable to expect people to keep exact timings of a daily commute, but it isn't a guaranteed victory. A really good (expensive) lawyer might even be able to pick apart the GA calculation of their 'average'. It might be that most people don't register when claiming, so they have 1 claim per 'person', vs the defendant who registered because they have a season ticket or needed to make multiple claims. But again, no guarantee of victory, only that it's going to cost a lot of money.

So you settle, because what is £1k when you could be talking a conviction, fine, criminal record, stress, time taken up and possibly losing your job.
 

Horizon22

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Given most people have admitted they made at least one claim in error, and so many have opted to settle instead of writing back and telling GA to go forth and multiply (has anyone here done that?), and now we hear of someone going to the press who has been claiming for almost every single day they travelled, I am going to need quite a lot of convincing that this is just some evil fishing trip by GA.

If everyone who made a claim was getting a letter, that might go some way to convincing me otherwise. For now, I think I'll side with those giving explanations who have actually worked in law/fraud prevention.

It's particularly laughable that someone has suggested that people who have been asked to explain abnormal claims should seek compensation for simply being asked. When you get asked for ID in a supermarket to buy beer, do you get outraged and demand to speak to the manager and ask for money for the embarrassment caused?!

This is quite a key point. I think every individual in this thread who has had one of these letters has either
a) admitted they did submit some 'fraudulent' claims using Delay Repay Genie / similar system
b) Has realistically been delayed but may have slightly exaggereated a few of them
c) Has misunderstood DR in terms of a cancelled train and not getting the next available (e.g. going for a drink).
d) Has repaid a sum of some description to GA.

This seems to me therefore that GA's investigation has been reasonably spot on. Now you can ask questions about why these claims got through in the first place but I would guess that individual claims don't flag up so often if the operator can see that yes X train was delayed by Y minutes and that's the claim put in, its accepted. By going through a larger dataset (12 months say), then you can start to see patterns where you would not individually be able to.

I am intrigued if there are any posters who flat-out refute GA's investigation, but I haven't see any (or they've been drowned out in the thread).
 

AlterEgo

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Say you made 100 legitimate claims (you were delayed 100 times), but managed to mix up 2 or 3 so that the dates were transposed with days you didn't travel or a delay didn't occur. GA identify those as suspicious claims, and then send a letter out saying they have detected a suspicious pattern from you for some of your claims. Pay up the full amount of the 100 or we'll report you to the fraud squad. They don't say what claims, they don't say how many, just that 'some' of your 'more than average' claims look suspicious and you give everything back, plus a fee, to make this go away.

You don't seem to have the option to fix the incorrect claims (past the cut-off period, too) or have any way to get more details, and as the claims were accepted you have no real evidence saved from that far back. It's a shake-down.

And if it went to court, it could easily go against you. GA can prove 2 of your claims are fraudulent, which casts doubt on the others. You've claimed more than the 'average' GA commuter and you have no evidence of your journeys. A good lawyer might be able to argue that 2 out of 100 is a fairly acceptable error ratio for a data entry task, or that it isn't reasonable to expect people to keep exact timings of a daily commute, but it isn't a guaranteed victory. A really good (expensive) lawyer might even be able to pick apart the GA calculation of their 'average'. It might be that most people don't register when claiming, so they have 1 claim per 'person', vs the defendant who registered because they have a season ticket or needed to make multiple claims. But again, no guarantee of victory, only that it's going to cost a lot of money.

So you settle, because what is £1k when you could be talking a conviction, fine, criminal record, stress, time taken up and possibly losing your job.
Sorry but no court is going to convict you on that basis. This is way above the expertise grade of this forum, but getting a conviction for fraud is quite difficult and something of the sort you outline probably wouldn’t even be taken on by the CPS.
 

robbeech

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Sorry but no court is going to convict you on that basis. This is way above the expertise grade of this forum, but getting a conviction for fraud is quite difficult and something of the sort you outline probably wouldn’t even be taken on by the CPS.
I'd be inclined to agree on the specific terms but can understand why people wouldn't risk it, particularly if they've read this forum for any length of time and seen how people get prosecuted successfully despite having evidence.

And we must remember that fraud itself is just one of many avenues they could take. They could be forced to repay ALLL of their claims for example, plus and admin fee, which might amount to thousands of pounds, this doesn't have to be called fraud.
 

AlterEgo

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This is quite a key point. I think every individual in this thread who has had one of these letters has either
a) admitted they did submit some 'fraudulent' claims using Delay Repay Genie / similar system
b) Has realistically been delayed but may have slightly exaggereated a few of them
c) Has misunderstood DR in terms of a cancelled train and not getting the next available (e.g. going for a drink).
d) Has repaid a sum of some description to GA.

This seems to me therefore that GA's investigation has been reasonably spot on. Now you can ask questions about why these claims got through in the first place but I would guess that individual claims don't flag up so often if the operator can see that yes X train was delayed by Y minutes and that's the claim put in, its accepted. By going through a larger dataset (12 months say), then you can start to see patterns where you would not individually be able to.

I am intrigued if there are any posters who flat-out refute GA's investigation, but I haven't see any (or they've been drowned out in the thread).
There appear to be a couple who were correctly identified as having made incorrect claims - that is, claims where they didn’t travel at all. So far, so good. But it turns out those couple of posters actually had valid reason to submit an abandoned journey claim through a separate process. Those people are innocent of fraud although we can see why GA’s methodology has seen them caught up along with everyone else. In those cases, GA ought to have shrugged and said “well, okay then”, and they’ve hardly garnered any additional sympathy by taking money from those people and still saying “they’re fraudulent anyway”.
 

Horizon22

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You might say GA have fraudulently obtained a repayment of money. What's the phrase: demanding money with menaces?

How so? By asking questions? Yes the letter comes off as fairly harsh but they are asking for information for an alleged offence.

There appear to be a couple who were correctly identified as having made incorrect claims - that is, claims where they didn’t travel at all. So far, so good. But it turns out those couple of posters actually had valid reason to submit an abandoned journey claim through a separate process. Those people are innocent of fraud although we can see why GA’s methodology has seen them caught up along with everyone else. In those cases, GA ought to have shrugged and said “well, okay then”, and they’ve hardly garnered any additional sympathy by taking money from those people and still saying “they’re fraudulent anyway”.

Yes but for that I can understand that the abandoned journey process can appear more confusing and they'd consider the DR process the one to utilise, which I think is understandable.
 

robbeech

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There appear to be a couple who were correctly identified as having made incorrect claims - that is, claims where they didn’t travel at all. So far, so good. But it turns out those couple of posters actually had valid reason to submit an abandoned journey claim through a separate process. Those people are innocent of fraud although we can see why GA’s methodology has seen them caught up along with everyone else. In those cases, GA ought to have shrugged and said “well, okay then”, and they’ve hardly garnered any additional sympathy by taking money from those people and still saying “they’re fraudulent anyway”.
I would rather hope those who are fighting GA's corner to the death can at least bring themselves to see why other people immediately question things when we come across this type of attitude from the operator.
 

AlterEgo

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I would rather hope those who are fighting GA's corner to the death can at least bring themselves to see why other people immediately question things when we come across this type of attitude from the operator.
Of course. But clearly there is a sensible middle ground. For me, it seems the following are all concurrently true:

1) GA has a lot of fraud and has put into place a blunt tool process to identify customers who have been defrauding them.
2) GA is entitled to pursue and investigate the alleged frauds and is entitled to ask questions of those it suspects, as well as withold evidence from those people in case they need to disclose it at a later stage.
3) GA’s attitude to the people who should have filed a different sort of claim stinks.
 

sheff1

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After explaining that I had unwittingly (wrongly) claimed delay repay for an “abandoned journey” .....total of 4 journeys over the last 15 months totalling £35 in paid out compensation I was informed that the delay repay dept is separate from customer services and that ignorance of the law is no excuse blah blah and that the compensation claims were still fraudulent
So GA stated that ignorance of the law is no excuse and then went on to confirm their ignorance of the law.
 

Hadders

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Perhaps GA should do this check when people make the claim, rather than paying out and then launching an investigation 18 months later? If there is a pattern of behaviour building up, investigate it as it becomes apparent. To go on a fishing expedition now, when they know damn well that people are exceptionally unlikely to have any evidence to support their claim is dishonest. Those being investigated might well be justified in asking GA why they did not challenge claims at the time. If nothing else it implies GA's delay repay payment process is less than robust.
I absolutely agree with this. If a claim for a 2 hour delay has been submitted by a passenger in error then GA should have rejected it. It seems that GA have paid out claims en-mass and 18 months later are looking into the detail. This doesn't seem acceptable to me.

After explaining that I had unwittingly (wrongly) claimed delay repay for an “abandoned journey” .....total of 4 journeys over the last 15 months totalling £35 in paid out compensation I was informed that the delay repay dept is separate from customer services and that ignorance of the law is no excuse blah blah and that the compensation claims were still fraudulent and “how would I like to continue ?”...long story short I work in the city and can’t risk a blot on my copybook and so settled for a total sum less than £100.
Maybe I watch too many court room dramas on TV but would you risk your career on a moot point of train bye laws?GA obviously think not
Given that many TOCs require claims to be submitted through the Delay Repay system I think it's a bit rich of GA to be requiring these claims to be repaid. I understand why you feel the need to settle but I would certainly raise this with your MP and also consider raising a complaint via Transport Focus. Perhaps the Rail Ombudsman might be interested as well (although they do seem to struggle with anything slightly complex!)
 

gingerheid

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But you are alleging fraud and dishonesty on the part of GA when there is no evidence of that either.

After explaining that I had unwittingly (wrongly) claimed delay repay for an “abandoned journey” .....total of 4 journeys over the last 15 months totalling £35 in paid out compensation I was informed that the delay repay dept is separate from customer services and that ignorance of the law is no excuse blah blah and that the compensation claims were still fraudulent and “how would I like to continue ?”...long story short I work in the city and can’t risk a blot on my copybook and so settled for a total sum less than £100.
Maybe I watch too many court room dramas on TV but would you risk your career on a moot point of train bye laws?GA obviously think not

(My bold)

BusterEdwards appears to have used the wrong form to make an otherwise valid claim. There could never be any possible question that this is fraud. There is no question of a dishonest state of mind, and there is no question of an intention to make a gain.

However if what BusterEdwards says is true then the test of whether GA committed fraud comes down to whether they were genuinely so stupid that they believed that this was true, despite the fact that it self evidently is not.

I find it genuinely unlikely that anyone could be so stupid as to think that this was true, but the possibility exists and perhaps they might be.
 
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