Gee Mehta says he knew nothing about subrogation before he was first approached to serve as finance chief of Intellivo, a company that focuses exclusively on the area.
But, after he did some more research, he came to see the relatively arcane practice as an “untapped financial lever” that could help organizations bring down health care costs.
“Health care costs are continuing to rise, and the demand on the health care system overall is just growing,” says Mehta, who joined Intellivo in July 2025. “I decided to make the plunge.”
In a nutshell, in a subrogation case, an insurer looks to recoup money it paid to an insured person by seeking compensation from the at-fault party. An example might work like this: You’re injured in a car wreck that was no fault of your own. Your car insurer pays for your car repairs and health care bills, and then seeks compensation from the individual who caused the accident.
It’s a seemingly straightforward legal concept that reportedly dates back to the days of the Roman Empire. But ask around, and you’ll quickly find that subrogation provokes strong responses both for and against the practice.
Over the years, firms like Intellivo and others have sprouted up and carved out a lucrative niche in subrogation, while some observers see the practice as extraordinarily harsh in some cases. But those on both sides would agree that finance teams should, at the very least, familiarize themselves with the details of the practice to avoid unfortunate surprises. As Intellivo officials put it in a blog last year: “While it may seem like an opaque, behind-the-scenes process, its impact is far-reaching.”
Leaving dollars on the table?
Mehta came to Intellivo after several years running finance for private equity-backed firms. While he wasn’t familiar with subrogation at the outset, he’s since become a champion for it. The practice, he says, can benefit both self-funded health plans and employers who use them.
In his view, it’s simply a tool to “recoup the dollars that the health plan should not be paying.” He pointed to a hypothetical example of a company that pays $2 billion in claims each year. If subrogation can recover even 1% of that, that could amount to upwards of $20 million.
“I don’t care how big the organization is; $20 million is a large check,” Mehta says.
“These are actual dollars found on the table,” he adds. “Not only do they go to the company’s bottom line, but these dollars help offset the health care costs that employees are going to bear.”
Intellivo has evidently had success in the area, having landed on Deloitte’s North America Technology Fast 500 list in late 2025. The list ranks the “fastest-growing” companies in North America by revenue across a range of industries, including tech, fintech and life sciences. From 2021 to 2024, Intellivo reported a 154% increase in revenue.
The company has competitors, such as UnitedHealth Group’s Optum arm, SubroIQ and Latitude Subrogation Services. But Mehta says Intellivo differentiates itself by focusing solely on subrogation, where others may also fold in other “cost containment services.” The company also touts a “seamless, friction-free process” that doesn’t even require any contact with a plan member, as Intellivo CEO Laura Hescock put it in a November 2025 news release.
Companies like Intellivo aren’t necessarily an entirely new phenomenon. Roger Baron, a retired law professor at the University of South Dakota, describes the rise of such firms as a “cottage industry.”
While he says he sees subrogation as a more reasonable solution in the context of property damage, he maintains that some applications in the health care space have “manifested in rather disastrous ways.”
He points back to an infamous case from the late aughts involving Walmart, which sued an employee who received a settlement with a trucking company after she was in a motor vehicle accident that left her severely brain-damaged. Walmart had initially paid for her health care claims, but when the company learned of the settlement, the retailer initiated subrogation to get back what it deemed to be its fair share.
The employee had even brought her appeal all the way up to the U.S. Supreme Court to hear her case, and was denied. But Walmart eventually relented and dropped the case in the wake of damning press coverage and public anger.
Mehta with Intellivo acknowledges that there “can certainly be difficult and challenging cases from time to time.”
“Each client controls plan language options like the make-whole doctrine, and the approach to difficult cases,” he says. “As the provider of subrogation services for our clients, we carry out the case approach established by our clients. However, our experience is that our clients are sensitive and thoughtful about distinctively challenging cases.”
And Baron himself acknowledges that “a lot of claims aren’t that bad.”
“But some of them are just horrendous,” he says.
Dave Place, an attorney who’s worked on subrogation plans on behalf of health plans and others for 15 years, would know. He says he “switched sides” back in 2012 and came to represent victims. The money recovered in subrogation cases, he notes, “comes from an injury victim.” Before he launched his own law firm, he had worked on several cases in Southern California, where Kaiser Permanente’s presence looms large.
One of his final straws, he says, came when he was pursuing a case against a newly engaged couple who had been injured by a drunk driver. One half of the couple was left paralyzed from the incident.
Place also takes issue with the idea that subrogation cases ultimately bring down health care costs.
“The idea that subrogation dollars coming in enables these companies to lower premiums and costs, there’s just zero evidence of that,” he says.
‘Not the bad guys’
Ashton Kirsch, a shareholder with subrogation law firm Matthiesen, Wickert & Lehrer, says subrogation is much more nuanced than it appears on the surface. To start, he notes, insurance carriers have a “policy duty” to engage in the practice.
“If they don’t, they’re arguably committing bad faith against their insurance,” Kirsch says. “The insurance carriers aren’t the bad guys; they’re doing what their policy tells them to do.”
While he’s aware there are some cases that are unfair that may have been “highly sensationalized,” Kirsch maintains that subrogation has, in some cases, brought about positive changes to various industries over the years.
He cites examples of subrogation cases brought against manufacturers that forced them, as an industry, to make their products safer.
Subrogation, in Kirsch’s view, also prevents injury victims from getting paid twice: once from their own insurer and again from the at-fault party’s insurer. “That’s the idea of subrogation,” he says. “You’re only getting money back when the policyholder has received a double recovery.”
Though those on opposing sides of the subrogation debate may have different takes on the ultimate results of the practice, they see value in getting a firm handle on how it works. “Understand what it is, and what it isn’t,” says Kirsch. “Understand that subrogation is not debt collections.”
Baron advises finance leaders to consider asking third-party subrogation providers whether they have protections in place for “situations where there might be undue hardship.”
Though subrogation is rarely something that most CFOs outside the insurance and legal space will need to handle on a day-to-day basis, sources agreed that finance teams should take time to get a better grasp on their insurer’s policies on the matter.
As Baron puts it: “This is a clause in an insurance policy that nobody appreciates until it happens to them.”
