This bill mandates human review of claims denials, restricts AI use in decision-making, and authorizes OIR to audit claim denials.
If you are an insurer in Florida, you must ensure claims denials are reviewed by qualified professionals and cannot rely on AI by the time this bill is enacted.
What do these statuses mean? ▼
Affected Industries
Topics
What This Means
The bill H1555 focuses on regulating how insurers handle claims denials, specifically restricting the use of AI and requiring human oversight. This legislation aims to enhance accountability in the insurance industry and protect consumer rights.
Key Provisions
- Claims denials must be reviewed and signed off by qualified human professionals.
- AI and automated systems cannot be the sole basis for denying claims.
- Insurers must maintain records of the human review process for denied claims.
- Insurers must include specific information in denial communications to claimants.
- OIR is authorized to audit claim denials.
Latest Legislative Action
Died in Insurance & Banking Subcommittee
Compliance Checklist
Who: Surplus lines insurers
Penalty: Potential penalties from OIR audits.
Who: Surplus lines insurers
Penalty: Potential penalties from OIR audits.
Related & Companion Bills
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