Works Weekends

Rawlings frequently shows up at the office on weekends. He says he has no close friends, no children and that the only visitors to his home are all business-related. He says he plans to work until he dies.

He monitors expenses, approving amounts as low as $6. He ordered photos on desks be placed in black and silver frames. Coats must be hung in closets, not on the backs of chairs. His father John built one of the 10 largest congregations in the U.S., hosted a religious radio show and mentored evangelist Jerry Falwell, who officiated at the 2007 funeral of Rawlings’s mother, Orelia.

In the 1980s, Rawlings’s small practice represented casualty insurers like Allstate Corp. and the Kentucky Farm Bureau. He soon became familiar with the legal concept known as subrogation, which allows insurers to recover costs when another party is responsible for the damage.

If a building is destroyed by a fire caused by a faulty furnace, the property insurer can seek costs from the furnace maker. Rawlings noticed attorneys often included medical costs. He had an epiphany: Subrogation could apply to those too.

“The medical expense dawned on me one day,” Rawlings says. “Why isn’t this money going back to who it belongs to?”

New Strategy

The answer was that insurers were set up to pay claims, not to chase damages from lawsuits. He told Humana Inc., a Louisville-based health insurer, that he could bring a windfall. The first month, Rawlings identified 200 cases, but sifting through claims on paper was time-consuming.

In 1987, a Humana employee said she could create a printout of select payments he wanted. For two days, Rawlings searched billing manuals, finding codes for things like broken bones and head trauma -- the kinds of injuries caused by auto accidents, falls and violent crimes. The resulting data dump was a treasure trove.

Rawlings says he was so successful that Humana cut ties with his company and helped fund a competing subrogation firm. Today, dozens of companies and law firms specialize in health- care subrogation. Xerox’s business recovered $1 billion in the past three years. A UnitedHealth Group Inc. unit, Optum Inc., is also a major player.