A new bill in Florida aims to limit how insurers use artificial intelligence in claims handling. Senate Bill 202, filed by Sen. Jennifer Bradley, would require that only human employees—not AI—make the final call when a claim is denied.
The legislation defines “AI,” “machine learning system,” and “algorithm,” and lays out testing standards for outputs.
It also requires insurers to keep records documenting the professional responsible for the denial decision.
Insurers must detail in their manuals how AI is used in the claims process and send written confirmation to policyholders that a denial wasn’t based solely on AI.
The Florida Office of Insurance Regulation would have authority to enforce compliance through market conduct exams or other oversight tools.
The proposal echoes draft model legislation circulated by the National Council of Insurance Legislators earlier this year.
J.P. Wieske, co-founder of the American InsurTech Council and a former Wisconsin deputy insurance commissioner, said Florida’s bill contains sweeping definitions of AI and algorithms that could complicate compliance.
He also noted that forcing human intervention on denials could disrupt long-standing claims practices. Health insurers process billions of claims annually, most through automated systems designed to handle routine, easily verifiable transactions.
When I was doing it back in the 1990s, probably close to 50% of claims were never seen by human and there’s even a higher percentage of that now.
J.P. Wieske, co-founder of the American InsurTech Council and a former Wisconsin deputy insurance commissioner
If passed, the law would create one of the country’s stricter state-level checks on insurers’ use of AI in claims adjudication, signaling a regulatory push to balance automation with accountability.
