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FL S0794

FL S0794: Mandatory Human Reviews of Insurance Claim Denials Verified

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Disclaimer: This page provides general informational summaries only and does not constitute legal advice. AI-generated content may contain errors. Always consult a qualified attorney for guidance specific to your situation. Read full disclaimer →
AI Summary

This bill mandates that insurance claim denials be made by qualified human professionals, prohibiting sole reliance on AI.

Business Impact

If you are an insurer in Florida, you must ensure that claim denials are made by qualified human professionals by January 1, 2026, or face regulatory scrutiny.

State
Florida
Bill Number
S0794
Status
Enacted
Risk Level
High
Category
Comprehensive
Effective Date
Jan 1, 2026
Last Action
Jun 16, 2025
Last Verified
May 4, 2026
Data Updated
May 4, 2026
Version
v2
What do these statuses mean?
Introduced — Filed in the legislature; not yet heard in committee
In Committee — Assigned to and being reviewed by a legislative committee
Passed — Approved by one or both chambers; awaiting further action
Signed / Enacted — Signed into law by the governor; may or may not be in effect yet
Dead / Vetoed — Vetoed, failed to pass, or session expired without action
Unknown — Status data not yet available or awaiting classification

Affected Industries

Insurance Finance

Topics How we classify →

What This Means

The newly enacted Florida bill S0794 requires that all insurance claim denials be made by qualified human professionals, explicitly prohibiting the use of AI or algorithms as the sole basis for such decisions. The Financial Services Commission is authorized to adopt rules to implement the section, enhancing accountability and transparency in the claims process, impacting insurers across the state.

Key Provisions

Latest Legislative Action

Died in Appropriations Committee on Agriculture, Environment, and General Government

Bill Sponsors

Name Role District
Sponsor
Sponsor SD-006

Roll Call Votes

S · Senate Banking and Insurance · Mar 25, 2025
9 Yea 0 Nay 1 Other Passed ✓

Amendments (1)

Senate Committee Amendment #861188 Pending 2025-03-25

Related & Companion Bills

Florida S0202 — Mandatory Human Reviews of Insurance Claim Denials Florida H0527 — Mandatory Human Reviews of Insurance Claim Denials Florida H1555 — Insurers' Liabilities and Responsibilities

Full Legal Analysis

The bill S0794 requires that any decision to deny an insurance claim or any portion thereof must be made by a qualified human professional, thereby prohibiting the use of algorithms, artificial intelligence, or machine learning systems as the sole basis for such decisions. Insurers are mandated to maintain detailed records of the actions taken by these professionals, including their names, titles, and the rationale behind claim denials. Additionally, insurers must communicate clearly with claimants regarding the decision-making process, ensuring that the involvement of human professionals is transparent. The Financial Services Commission is authorized to adopt rules to implement the section. This legislation aligns with a growing trend in various states to regulate the use of AI and automated decision-making in sensitive areas such as insurance, aiming to protect consumers and ensure fair practices. Insurers will need to review and possibly overhaul their claims handling processes to meet these new legal standards, reflecting a significant shift towards human oversight in automated systems.

Official Source


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