Fee petition mechanics · Updated July 2026
California Insurance Fraud Prevention Act IFPA qui tam attorney fee petition mechanics: date of fraudulent insurance claim submission in insurance company claims management system as primary Welch anchor, Ins. Code § 1871.7 mandatory attorney fees — pure Ketchum no Dague; ONLY page where plaintiff is a QUI TAM RELATOR filing in the name of the State of California and primary Welch anchor is in INSURANCE COMPANY'S OWN CLAIMS MANAGEMENT SYSTEM; DISTINCT from California False Claims Act Gov. Code § 12652, workers' comp anti-retaliation Lab. Code § 132a, and insurance bad faith Brandt fees
California Insurance Fraud Prevention Act qui tam enforcement (Ins. Code § 1871.7 — IFPA — enacted 1993, SB 1899; substantially amended 2001, 2007; § 1871.7(a): it is unlawful to knowingly employ runners, cappers, steerers, or others to procure clients or patients to perform or obtain services or benefits that would be the subject of a claim for workers' compensation insurance, automobile insurance, or health insurance; § 1871.7(b) authorizes civil action by the California Department of Insurance, any political subdivision of the state, or by any person (qui tam relator) in the name of the state — the qui tam provision allows private individuals with firsthand knowledge of the fraud scheme to bring suit in the state's name and share in the recovery; § 1871.7(e): civil fine of $5,000–$10,000 per fraudulent claim plus three times the amount of each fraudulent claim — the treble damages and per-claim fines apply to organized fraud schemes involving runners, cappers, and steerers; § 1871.7(g)(2): the qui tam relator's share of the recovery is 30–40% of the proceeds; § 1871.7(g)(3): if the California Department of Insurance or DA has initiated a criminal prosecution of the defendant, the § 1871.7 qui tam civil action is stayed pending completion of the criminal proceedings; § 1871.7(g)(4): 'The qui tam plaintiff shall also be entitled to an amount for reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorneys' fees and costs' — MANDATORY attorney fees to the prevailing qui tam relator; covered insurance fraud types: workers' compensation insurance fraud, automobile insurance fraud, and health insurance fraud through organized runners/cappers/steerers schemes; the ONLY fee-petition-mechanics page where the plaintiff is a QUI TAM RELATOR (an individual who files suit in the name of the State of California) and the primary Welch anchor is in the INSURANCE COMPANY'S OWN CLAIMS MANAGEMENT SYSTEM [Guidewire ClaimCenter (largest market share for P&C insurance), Duck Creek Claims, Majesco P&C Claims, Sapiens Decision (used by major specialty insurers), Fineos Workers Compensation (specialty WC platform), OneShield Claims, INSIS Insurance Suite, Insurity Loss Control, Applied Epic Claims — each records the fraudulent claim submission date, claim intake date, claim number assignment date, and initial adjuster assignment date on the insurance company's own institutional claims management calendar entirely outside qui tam relator attorney's scheduling control]; federal False Claims Act (31 U.S.C. § 3730) covers fraud against federal government programs (Medicare, Medicaid, CalTrans contracts, other federal grant programs) — NOT private insurance fraud — therefore federal FCA attorney fees under § 3730(d) are not applicable to IFPA § 1871.7 qui tam; California IFPA is state-only → pure Ketchum, no Dague constraint from City of Burlington v. Dague 505 U.S. 557 (1992); DISTINCT from California False Claims Act (Gov. Code § 12652) [§ 12652 qui tam covers fraud against the STATE GOVERNMENT — Medi-Cal reimbursement, CalTrans contracts, state agency procurement — DISTINCT from § 1871.7 which covers fraud against PRIVATE INSURANCE COMPANIES including workers' comp carriers, auto insurers, and health insurers; the defendant class and the injured party are fundamentally different: § 12652 protects the state treasury; § 1871.7 protects private insurance markets and ultimately policyholders through premium stability]; DISTINCT from workers' comp anti-retaliation (Lab. Code § 132a) [§ 132a protects employees who file legitimate workers' comp claims from employer retaliation — entirely different liability theory from § 1871.7 which targets fraudulent claims by runners/cappers/steerers]; DISTINCT from insurance bad faith (Ins. Code § 790.03(h) / Brandt fees) [bad faith = insurer's tortious refusal to pay a valid claim to its own insured — DISTINCT from § 1871.7 IFPA which targets fraudulent claims submitted by organized fraud schemes to the insurer]; Ketchum v. Moses 24 Cal.4th 1122 (2001); PLCM Group Inc. v. Drexler 22 Cal.4th 1084 (2000); Hensley v. Eckerhart 461 U.S. 424 (1983) lodestar from DATE OF FRAUDULENT CLAIM SUBMISSION; Missouri v. Jenkins 491 U.S. 274 (1989) fees-on-fees — solos billing hourly on § 1871.7 qui tam attorney fee recovery generate three billing gaps: § 1871.7(a) runners/cappers/steerers scheme analysis and relator standing advisory calls (7 clients × 2 calls × 42 min × 55% untracked ≈ 5.39 hrs = $1,617–$2,695/year at $300–$500/hr), insurance claims management system calendar and CDI Fraud Division calendar and DA prosecution calendar advisory calls (6 clients × 3 calls × 44 min × 55% ≈ 7.26 hrs = $2,178–$3,630/year), and § 1871.7 qui tam Ketchum fee petition advisory calls (5 clients × 2 calls × 44 min × 55% ≈ 4.03 hrs = $1,210–$2,017/year), for an annual billing gap of $5,005–$8,342.
TL;DR
ClaimHour captures every § 1871.7(a) runners/cappers/steerers scheme analysis and relator standing advisory call that starts the § 1871.7 fee documentation period from the DATE OF FRAUDULENT INSURANCE CLAIM SUBMISSION (in the INSURANCE COMPANY'S OWN CLAIMS MANAGEMENT SYSTEM: Guidewire ClaimCenter/Duck Creek/Majesco/Fineos WC — fraudulent claim submission date, claim number assignment date, SIU notification date entirely outside qui tam relator attorney's scheduling control; § 1871.7[g][4] mandatory attorney fees; pure Ketchum no Dague; ONLY page where plaintiff is a QUI TAM RELATOR and Welch anchor is in INSURANCE COMPANY'S CLAIMS MANAGEMENT SYSTEM; DISTINCT from Gov. Code § 12652 California False Claims Act [government fraud vs. private insurance fraud], Lab. Code § 132a workers' comp anti-retaliation [employee protection vs. fraud scheme targeting], and Ins. Code § 790.03[h] Brandt fees [bad faith denial vs. fraudulent claim submission]), every insurance claims management system calendar and CDI Fraud Division investigation calendar and DA prosecution calendar advisory call on external institutional calendars entirely outside attorney control, and every § 1871.7 qui tam Ketchum fee petition advisory call — passively, no timer, no audio, no call contents. $29–$59/mo. No PMS required.
§ 1871.7(a) runners/cappers/steerers scheme analysis and relator standing assessment: calls on the insurance claims management system calendar
The DATE OF FRAUDULENT INSURANCE CLAIM SUBMISSION is the primary Welch temporal anchor for § 1871.7 IFPA qui tam attorney fee billing. This date is in the INSURANCE COMPANY'S OWN CLAIMS MANAGEMENT SYSTEM CALENDAR DATE. The Hensley lodestar starts from this date for five reasons: (1) Guidewire ClaimCenter (the largest market share claims management platform for property and casualty insurers, used by major California workers' comp carriers including State Compensation Insurance Fund, ICW Group, Zenith National), Duck Creek Claims (used by mid-size P&C carriers), Majesco P&C Claims, Sapiens Decision, Fineos Workers Compensation (specialty WC claims platform), OneShield Claims, INSIS Insurance Suite, Insurity Loss Control, and Applied Epic Claims each record the fraudulent claim submission date, claim intake date, claim number assignment date, and initial adjuster assignment date on the insurance company's own institutional claims management calendar entirely outside qui tam relator attorney's scheduling control; (2) the claim number assigned by the insurance company's claims management system is the primary document identifier for all subsequent investigation and litigation: the claim number ties the fraudulent claim to the runner/capper/steerer referral network — the claim number and submission date are the foundation of the § 1871.7(e) per-claim fine calculation; (3) the insurer's Special Investigations Unit (SIU) notification date is in the insurer's claims management system: major insurers (State Farm, Farmers, Allstate, CSAA, Mercury, ICW Group) maintain specialized SIU departments that are notified when claims show patterns consistent with fraud — the SIU notification date is recorded in the insurer's claims management system and represents the insurer's internal recognition of the fraud scheme; the SIU notification date is on the insurer's institutional claims management calendar entirely outside the qui tam relator attorney's scheduling control; (4) the claim payment or denial date is in the insurer's claims management system: if the insurer paid the fraudulent claim before discovering the fraud, the payment date establishes the § 1871.7(e) base amount for the treble damages calculation; if the insurer denied the fraudulent claim after SIU investigation, the denial date is the alternative anchor for the fraud scheme's exposure; both dates are on the insurer's institutional claims management calendar; (5) the date of the runner/capper/steerer referral is in the fraud operation's own records — but because these records are often in the defendant's business management system (medical practice management system, auto body shop repair order system, legal case management system for attorney runner operations), the comparison between the referral date (in the defendant's records) and the claim submission date (in the insurer's claims management system) establishes the causal link required by § 1871.7(a).
Three initial advisory call types generate untracked billing from the fraudulent claim submission date: (1) § 1871.7(a) runners/cappers/steerers scheme qualification and relator standing assessment advisory — arrives when qui tam relator retains counsel (scheme analysis: [a] assess whether the scheme involves 'runners, cappers, or steerers' within the meaning of § 1871.7(a): the statute requires organized procurement — an individual who refers patients or claimants to a medical provider, auto body shop, or attorney in exchange for compensation is a 'runner, capper, or steerer'; assess the specific roles of the participants in the scheme and whether each role meets the statutory definition; [b] assess the § 1871.7(j) public disclosure bar: the IFPA qui tam action is barred if the relator's information is based substantially on publicly disclosed information (a government report, news article, or public court record) and the relator is not the original source of the information — the public disclosure bar is a threshold standing issue; [c] assess the relator's firsthand knowledge: the relator must have direct, independent knowledge of the fraud scheme — not derived from the public disclosures — to establish original source status under § 1871.7(j); document the specific facts the relator personally witnessed, participated in, or directly observed; [d] assess covered insurance type: § 1871.7 covers workers' compensation insurance fraud, automobile insurance fraud, and health insurance fraud — confirm the claims at issue involve one or more of these covered insurance types; staged auto accidents (involving auto body shops and medical clinics receiving runner referrals) are the most common § 1871.7 scheme; [e] assess potential defendant class: the § 1871.7 defendant may be the runner/capper/steerer, the medical provider receiving the referred patients, the auto body shop receiving the referred vehicles, or the attorney receiving the referred clients — each participant in the scheme who 'knowingly employs' runners/cappers/steerers is a potential defendant; 42–48 min per call); (2) insurance claims management system evidence and fraud scheme documentation advisory — arrives when fraud scheme evidence is being assembled (documentation analysis: [a] obtain the insurance company's claims management system records for the fraudulent claims: a civil subpoena to the insurer (State Farm/Farmers/Allstate/CSAA/Mercury/ICW Group/SCIF) requests the claim files for all claims identified in the relator's disclosure — the claims management system records (Guidewire ClaimCenter/Duck Creek/Fineos WC) are the primary evidentiary foundation; [b] obtain the insurer's SIU investigation records: request the insurer's SIU investigation records for the fraud scheme — the SIU file typically includes the fraud detection date, the names of the runner/capper/steerer suspects identified by the SIU, and the SIU referral to CDI or law enforcement; [c] compare claim submission dates against referral dates: the runner/capper/steerer referral date (in the defendant's practice management system or auto body shop repair order system) compared against the claim submission date (in the insurer's claims management system) establishes the causal referral link required by § 1871.7(a); [d] assess claim volume for § 1871.7(e) damages calculation: count the number of fraudulent claims identified across all insurer claims management systems — each fraudulent claim generates a $5,000–$10,000 civil fine plus treble the claim amount under § 1871.7(e); the total damages are calculated by multiplying the number of fraudulent claims by the per-claim fine and the treble damages formula; [e] assess whether the insurer's SIU has already referred the matter to CDI Fraud Division or law enforcement: if the insurer's SIU has made a referral, the CDI Fraud Division's investigation calendar may be running independently of the relator's qui tam action — the CDI investigation date and DA prosecution calendar will affect the § 1871.7(g)(3) stay determination; 42–48 min per call); (3) § 1871.7(g)(3) stay analysis and concurrent federal FCA assessment advisory — arrives before filing (strategy analysis: [a] assess the § 1871.7(g)(3) stay risk: if the California Department of Insurance or any District Attorney has initiated a criminal prosecution of any defendant in the qui tam action, the § 1871.7 civil action must be stayed pending the criminal prosecution — the stay can last years if the criminal prosecution is complex; assess whether any known criminal investigation is underway before filing; [b] assess concurrent federal FCA potential: if the fraud scheme involves billing Medicare or Medi-Cal (California Medicaid), the federal False Claims Act (31 U.S.C. § 3730) provides a concurrent qui tam action in federal court — federal FCA recoveries include mandatory attorney fees under § 3730(d)(1); the federal FCA is not Dague-constrained (§ 3730 is not a § 1983 civil rights statute) but the federal FCA relator share provisions (15–30% if the government intervenes, 25–30% if it does not) differ from the California IFPA relator share (30–40%); [c] assess in camera filing and seal: § 1871.7(b)(3) requires the qui tam complaint to be filed in camera and under seal for 60 days to allow the California Department of Insurance to investigate and determine whether to intervene — the 60-day seal period is a mandatory procedural step; [d] assess state intervention: if the CDI or DA intervenes, the relator's attorney fee rights under § 1871.7(g)(4) apply independently of whether the government or the relator drives the litigation; [e] assess defendant class for service: once the seal is lifted after government intervention determination, the complaint must be served on all defendants — identifying and locating all runner/capper/steerer participants (who often have transient addresses) requires investigation; 42–48 min per call). At 55% untracked: 7 clients × 2 calls × 42 min × 55% = 323.4 min / 60 = 5.39 hours = $1,617–$2,695/year at $300–$500/hr.
Insurance claims management system calendar, CDI Fraud Division investigation calendar, and District Attorney Organized Insurance Fraud Unit prosecution calendar: calls on three institutional calendars entirely outside attorney control
A California Ins. Code § 1871.7 IFPA qui tam case involves three concurrent external institutional calendars entirely outside the qui tam relator attorney's scheduling control: the insurance company's claims management system calendar [Guidewire ClaimCenter/Duck Creek Claims/Majesco P&C Claims/Sapiens Decision/Fineos Workers Compensation/OneShield Claims/Applied Epic Claims each record: (a) fraudulent claim submission date (the date the fraudulent claim was submitted to the insurer's claims management system — on the insurer's institutional claims management calendar entirely outside plaintiff attorney's scheduling control; this is the primary Welch anchor); (b) claim number assignment date (the date the insurer's claims management system assigned a unique claim number to the fraudulent claim — on the insurer's institutional calendar; the claim number is the primary document identifier for the § 1871.7 proceedings); (c) adjuster assignment date (the date the insurer assigned a claims adjuster to the fraudulent claim — on the insurer's institutional calendar); (d) SIU notification date (the date the insurer's Special Investigations Unit was notified of suspected fraud — on the insurer's SIU institutional calendar; major carriers' SIU departments [State Farm SIU, Farmers Special Investigations, Allstate SIU, CSAA SIU, ICW Group SIU, SCIF SIU] each maintain institutional SIU calendars entirely outside plaintiff attorney's scheduling control); (e) claim payment or denial date (the date the insurer paid or denied the fraudulent claim — on the insurer's institutional claims management calendar; if paid before SIU detection, the payment date is the base amount for the § 1871.7[e] treble damages calculation)]; the California Department of Insurance (CDI) Fraud Division investigation calendar [(a) CDI Fraud Division complaint intake date (the date CDI's Fraud Division received the complaint or SIU referral about the fraud scheme — on CDI's own institutional investigation calendar entirely outside plaintiff attorney's scheduling control; CDI Fraud Division Annual Report shows approximately 8,000+ complaints processed per year); (b) CDI investigation initiation date (the date CDI assigned an investigator and initiated a formal fraud investigation — on CDI's institutional calendar); (c) CDI SIU coordination date (the date CDI coordinated with the insurer's SIU on the fraud investigation — on CDI's institutional calendar; CDI has authority under Ins. Code § 1872.4 to subpoena insurer claims management records); (d) CDI referral to DA Organized Insurance Fraud Unit date (the date CDI referred the matter to the relevant county DA's Organized Insurance Fraud Unit for criminal prosecution — on CDI's institutional calendar; this referral date is critical because it may trigger the § 1871.7[g][3] stay of the qui tam civil action); (e) CDI administrative action date (if CDI initiates its own administrative action under § 1871.7[b] — the CDI's administrative action date is on CDI's institutional calendar)]; and the District Attorney Organized Insurance Fraud Unit criminal prosecution calendar [(a) DA investigation initiation date (the date the DA's Organized Insurance Fraud Unit initiated its criminal investigation of the fraud scheme — on the DA's institutional criminal investigation calendar entirely outside qui tam relator attorney's scheduling control; major California county DAs with active insurance fraud units: Los Angeles DA Organized Crime Division Insurance Fraud Section, Orange County DA Insurance Fraud Unit, Riverside County DA Insurance Fraud Unit, San Bernardino County DA Special Crimes Division, San Diego DA Economic Crimes Division); (b) search warrant execution date (the date the DA executed search warrants on the defendant's medical office, auto body shop, or law firm — on the DA's institutional criminal investigation calendar; search warrant execution often produces the documentary evidence supporting the § 1871.7 civil action); (c) arrest date (the date the DA arrested the defendant for criminal insurance fraud under Penal Code §§ 548–550 — on the DA's institutional calendar; the arrest date may be disclosed in public records); (d) criminal complaint or information filing date (the date the DA filed criminal charges in superior court — on the DA's institutional court filing calendar; the criminal charges filing date triggers the § 1871.7[g][3] mandatory stay of the qui tam civil action); (e) criminal disposition date (the date of the criminal trial verdict, guilty plea, or dismissal — on the DA's institutional court calendar; the criminal disposition date determines when the § 1871.7[g][3] stay of the qui tam civil action is lifted)]. Ketchum v. Moses 24 Cal.4th 1122 (2001). PLCM Group 22 Cal.4th 1084 (2000). Hensley v. Eckerhart 461 U.S. 424 (1983). Missouri v. Jenkins 491 U.S. 274 (1989) fees-on-fees.
Three concurrent external institutional calendar advisory call types generate untracked billing: (1) insurance claims management system calendar monitoring and SIU coordination advisory — arrives when insurer's claims records and SIU investigation are being obtained (claims calendar analysis: [a] subpoena the insurer's claims management system records (Guidewire ClaimCenter/Duck Creek/Fineos WC): a civil subpoena to the insurer during the unsealed phase of the qui tam action requests all claim files for the fraudulent claims identified in the relator's disclosure — the insurer's production deadline is on the insurer's compliance calendar; [b] subpoena the SIU investigation file: the insurer's SIU investigation file (which may identify other members of the runner/capper/steerer network not known to the relator) is a critical discovery item — obtain all SIU investigation records, referral correspondence with CDI and law enforcement, and CDI referral confirmation; [c] coordinate with the insurer as an interested party: in § 1871.7 qui tam actions, the insurance company is often willing to cooperate with the relator because the insurer is a victim of the fraud — the insurer's SIU personnel may provide declarations or testimony establishing the fraudulent claim submission dates and amounts; [d] monitor the claims management system records for additional fraud scheme participants: the insurer's claims management system may identify additional medical providers, auto body shops, or attorneys in the same runner/capper/steerer network who were not identified by the relator — expanding the defendant class may increase the § 1871.7(e) damages; 44–50 min per call); (2) CDI Fraud Division investigation calendar monitoring advisory — arrives when CDI investigation timeline affects the qui tam strategy (CDI calendar analysis: [a] monitor CDI's investigation initiation: if CDI has initiated a formal investigation, coordinate with CDI on the exchange of information — the § 1871.7(b)(3) in camera filing process allows CDI to assess the relator's disclosure during the 60-day seal period; [b] assess CDI's intervention decision: after the 60-day seal period (which may be extended), CDI must decide whether to intervene in the qui tam action — if CDI intervenes, CDI directs the litigation; if CDI declines to intervene, the relator proceeds independently; the intervention decision date is on CDI's institutional calendar; [c] monitor CDI referral to DA: if CDI refers the matter to the DA, the referral date triggers the § 1871.7(g)(3) stay analysis — once the DA files criminal charges, the qui tam action must be stayed; [d] assess CDI's administrative enforcement action: if CDI initiates its own § 1871.7(b) administrative enforcement action against any defendant (rather than intervening in the qui tam action), coordinate the administrative and civil timelines; 44–50 min per call); (3) DA Organized Insurance Fraud Unit prosecution calendar monitoring advisory — arrives when DA criminal prosecution creates a § 1871.7(g)(3) stay (DA calendar analysis: [a] monitor the DA prosecution timeline: if the DA's Organized Insurance Fraud Unit has filed criminal charges against any defendant in the § 1871.7 qui tam action, the civil action must be stayed under § 1871.7(g)(3) — monitor the DA's criminal prosecution calendar for the criminal disposition date that will lift the stay; [b] preserve evidence during the stay: during the § 1871.7(g)(3) stay of the qui tam civil action, the qui tam relator's attorney must preserve all evidence and maintain contact with the relator to avoid evidence loss; [c] coordinate evidence use from criminal prosecution: if the DA's criminal prosecution produces convictions or guilty pleas, the criminal judgment may support collateral estoppel on the liability issue in the § 1871.7 civil action — coordinate with the DA to obtain copies of the criminal judgment, plea agreement, and sentencing documents; [d] assess restitution order credit: if the criminal court orders restitution to the insurance companies as part of the criminal sentence, assess whether the restitution amount is credited against the § 1871.7(e) civil fine and treble damages — the coordination of criminal restitution and civil § 1871.7 recovery may affect the ultimate relator share under § 1871.7(g)(2); 44–50 min per call). At 55% untracked: 6 clients × 3 calls × 44 min × 55% = 435.6 min / 60 = 7.26 hours = $2,178–$3,630/year at $300–$500/hr.
§ 1871.7 mandatory qui tam attorney fee petition and pure Ketchum analysis: calls on the post-judgment fee petition calendar
Fee recovery for Ins. Code § 1871.7 IFPA qui tam is through § 1871.7(g)(4): 'The qui tam plaintiff shall also be entitled to an amount for reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorneys' fees and costs.' The § 1871.7 fee petition requires a Hensley lodestar from the DATE OF FRAUDULENT INSURANCE CLAIM SUBMISSION through § 1871.7(a) scheme analysis, relator standing assessment, claims management system record subpoena, CDI Fraud Division calendar monitoring, DA prosecution calendar monitoring, and the fee petition itself. § 1871.7(g)(4) fees are MANDATORY for the prevailing qui tam relator. Federal False Claims Act (31 U.S.C. § 3730) covers government program fraud — not private insurance fraud — therefore IFPA § 1871.7 qui tam is California state law only → pure Ketchum, no Dague constraint. Ketchum v. Moses 24 Cal.4th 1122 (2001). PLCM Group 22 Cal.4th 1084 (2000). Hensley 461 U.S. 424 (1983). Missouri v. Jenkins 491 U.S. 274 (1989) fees-on-fees.
Two § 1871.7 post-judgment advisory call types generate untracked billing: (1) § 1871.7(e) damages assembly and relator share and fee petition calculation advisory — arrives at judgment (damages and fee components: [a] § 1871.7(e) civil fines: $5,000–$10,000 per fraudulent claim — the number of fraudulent claims is established from the insurer's claims management system records; for a scheme involving 500 fraudulent claims, the civil fines range from $2.5 million to $5 million independently of the treble damages; [b] § 1871.7(e) treble damages: three times the amount of each fraudulent claim — the claim amounts are in the insurer's claims management system payment records; for 500 claims at an average of $3,000 each, treble damages are $4.5 million; [c] relator's share: § 1871.7(g)(2) provides the relator a 30–40% share of the recoveries — the relator's share is calculated on the net recovery after deduction of the attorney fees and costs under § 1871.7(g)(4); [d] § 1871.7(g)(4) mandatory attorney fees: the Hensley lodestar from the fraudulent claim submission date through all IFPA qui tam work and fee petition — mandatory for the prevailing relator; [e] Missouri v. Jenkins fees-on-fees: attorney fees for preparing the § 1871.7 fee petition are themselves recoverable — the fees-on-fees hours must be contemporaneously documented from the date the fee petition drafting begins; 44–50 min per call); (2) five Ketchum contingency factors identification and pure Ketchum analysis advisory — arrives at fee petition (Ketchum analysis: [a] uncertainty whether scheme involves sufficient 'runners, cappers, or steerers' to trigger § 1871.7(a) vs. a mere isolated billing error: at the fraudulent claim submission date, whether the defendant's referral system constituted an organized runner/capper/steerer scheme under § 1871.7(a) vs. a legitimate patient referral arrangement was not determinable without discovery of the defendant's internal records — this threshold factual uncertainty is a primary Ketchum positive contingency factor; [b] uncertainty whether relator has sufficient firsthand knowledge to avoid § 1871.7(j) public disclosure bar: at case inception, whether the relator's information was 'substantially based on publicly disclosed information' was uncertain — the public disclosure bar is litigated at the outset, creating outcome uncertainty; [c] CDI and DA coordination uncertainty creates timeline unpredictability: the § 1871.7(g)(3) mandatory stay of the qui tam action when the DA files criminal charges can extend the litigation by years — at case inception, whether the DA would file criminal charges (creating a stay) or decline prosecution (allowing the qui tam action to proceed) was uncertain; [d] relator's qui tam share uncertainty: § 1871.7(g)(2)'s 30–40% share depends on the actual recovery amount — which depends on the number of fraudulent claims proven and the per-claim amounts established from the insurer's claims management records; the actual recovery was not determinable at case inception; [e] insurance company litigation posture uncertainty: large carriers (State Farm, Farmers, Allstate, CSAA, Mercury, ICW Group) have substantial in-house fraud investigation and litigation teams and experienced outside counsel familiar with IFPA qui tam defense — the insurer's cooperation with the relator vs. the defendants' aggressive defense of the qui tam action was not predictable at case inception; 44–50 min per call). At 55% untracked: 5 clients × 2 calls × 44 min × 55% = 242 min / 60 = 4.03 hours = $1,210–$2,017/year at $300–$500/hr.
How ClaimHour fits California IFPA qui tam insurance fraud practice
California Ins. Code § 1871.7 IFPA qui tam solos billing hourly on § 1871.7(g)(4) attorney fee recovery — with § 1871.7(a) runners/cappers/steerers scheme analysis and relator standing advisory calls arriving when qui tam relators retain counsel after witnessing organized insurance fraud (DATE OF FRAUDULENT INSURANCE CLAIM SUBMISSION = primary Welch anchor; in the INSURANCE COMPANY'S OWN CLAIMS MANAGEMENT SYSTEM: Guidewire ClaimCenter/Duck Creek/Majesco/Fineos WC — fraudulent claim submission date, claim number assignment date, SIU notification date, claim payment or denial date entirely outside qui tam relator attorney's scheduling control; § 1871.7[g][4] mandatory attorney fees; pure Ketchum no Dague; ONLY page where plaintiff is a QUI TAM RELATOR; DISTINCT from Gov. Code § 12652 California False Claims Act [government fraud vs. private insurance fraud], Lab. Code § 132a workers' comp anti-retaliation [employee protection vs. fraud scheme targeting], and Ins. Code § 790.03[h] Brandt fees [insurer bad faith vs. fraudulent claim submission]), insurance claims management system calendar monitoring advisory calls on the insurer's institutional claims management calendar entirely outside plaintiff attorney's scheduling control, CDI Fraud Division investigation calendar monitoring advisory calls on CDI's institutional investigation calendar entirely outside plaintiff attorney's scheduling control, DA Organized Insurance Fraud Unit prosecution calendar monitoring advisory calls on the DA's institutional criminal prosecution calendar entirely outside plaintiff attorney's scheduling control, and § 1871.7 qui tam Ketchum fee petition advisory calls arriving at judgment — and if your § 1871.7 Hensley lodestar documentation must satisfy the contemporaneous-record standard with five Ketchum contingency factors from the DATE OF FRAUDULENT CLAIM SUBMISSION through scheme analysis, claims management system monitoring, CDI Fraud Division tracking, DA prosecution stay monitoring, litigation, and fee petition, ClaimHour was built for that gap.