Lawsuits provide a glimpse into what the industry can look like. Shaun Miller was riding his bike in California when a van plowed into him, leaving him paralyzed. Although Miller needed millions for lifelong care, the maximum available from the car’s auto insurer was $100,000.
‘Fairness and Decency’
Rawlings, representing Kaiser Permanente, demanded more than $33,000 to compensate the insurer for Miller’s medical expenses. Asking Rawlings to consider “simple fairness and decency,” Miller’s attorney offered $3,500. They compromised at $15,000.
Rawlings moved his company from downtown Louisville to rural LaGrange, Kentucky, eight years ago so that it would have ample room to grow. It now has 1,100 employees. At its three- story headquarters, most work in cubicles on floors as long as football fields.
Motivated by cash bonuses tied to how much they recover, they dig through court filings, scour newspaper articles and search Facebook, Twitter and Instagram for clues about how people were injured.
Eight Million Letters
One hundred technology workers, including four with doctorates in data mining, scan billions of claims from insurers. Charges for air ambulances, treatment of major traumas and almost any emergency room visit are flagged and investigated.
If you have received one of those annoying letters from your health insurer asking if a recent hospital stay was the result of an accident, blame Rawlings’ brainchild. His company alone generates eight million letters a year. Recently, a backroom print shop was cranking out mailings labeled “request for medical claim information” for Blue Cross Blue Shield of North Carolina.
Thousands of responses come in daily. As he gives a tour, construction crews put up steel columns for a wing to house almost 700 more employees.
Rawlings, 69 and six-foot-three, drinks a dozen cups of coffee a day. The son of a Baptist minister, he stops to talk with employees, addressing most by their first names; they call him Mr. Rawlings.