New Proposed Legislation in Florida Regarding AI Use in Claims Handling

Florida Legislature proposes mandatory human reviews of claim denials involving AI to ensure fair decision-making in insurance claims.
HB 527 (and companion bill SB 202) mandates human oversight for using AI in claims processing, requiring detailed guidelines in insurers’ claims handling manuals.
Legislation stipulates that a “qualified human professional” must independently analyze claims, review AI outputs for accuracy, and ultimately make the decision on paying or denying claims.
The proposal aims to address potential algorithm-driven inaccuracies, biases, and compliance with insurance regulation laws.
The new legislation aligns with a 2023 NAIC bulletin that emphasizes the need for AI governance in insurance companies to prevent inaccuracies and ensure regulatory compliance.
The proposed legislation is expected to face possible federal challenges, as recent executive orders limit states’ authority to enact their own AI regulations.

New Proposed Legislation in Florida Regarding AI Use in Claims Handling | Zelle LLP