In an issue stemming from the use of artificial intelligence in the insurance industry, a House panel Tuesday approved a proposal that would require humans to make ultimate decisions about denying claims or reducing claim payments.
The House Insurance & Banking Subcommittee unanimously approved the bill (HB 527) amid opposition from insurance-industry groups — but support from groups that represent hospitals and doctors.
“No Floridian should ever have a claim denied based solely on an automated output,” bill sponsor Hillary Cassel, R-Dania Beach, said. “HB 527 establishes a clear and reasonable safeguard.”
The bill makes clear that insurers could use artificial intelligence and algorithms in processing claims and making recommendations about approvals and denials. But it says a “carrier’s decision to deny a claim or any portion of a claim or a payment claim reduction must be made by a qualified human professional.”
Also, it would take steps such as requiring that insurers using artificial intelligence or algorithms in claims handling provide details in what are known as “manuals” that can be reviewed by insurance regulators.
Tuesday’s vote came amid what House Speaker Daniel Perez, R- Miami, has declared “Artificial Intelligence Week,” with House panels looking at a variety of issues involving the fast-developing technology.
President Donald Trump on Monday said he plans to issue an executive order that would prevent states from regulating artificial intelligence. But Cassel, an attorney, said such an executive order would not block her proposal because a decades-old federal law has given states authority over insurance regulation.
State Insurance Commissioner Michael Yaworsky last month told a Senate committee that he wants changes to make sure regulators can properly oversee AI use — though he did not go as far as Cassel’s proposal. Yaworsky said he wants to address issues such as disclosure when artificial intelligence is being used, auditing and understanding that companies have a “human in the loop that knows what that system is doing, has expertise on that.”
“This is a policy decision for the Legislature,” Yaworsky told the Senate Banking and Insurance Committee. “We don’t view it as a necessary benefit to eliminate the use of AI. That’s a legislative decision to make. But we do want to provide a path where, if it is being used, it is being used responsibly, known to the regulator.”
Cassel’s bill drew opposition Tuesday from representatives of the Florida Insurance Council, the American Property Casualty Insurance Association and the Personal Insurance Federation of Florida, which represents large national auto and property insurers. They expressed concerns, for example, that the bill could make it harder to quickly resolve claims and said the state’s insurance laws already address issues about fairly handling claims.
But the bill got support from groups such as the Florida Hospital Association and the Florida Medical Association, whose members submit insurance claims.
