The proposed bill amends Florida Statutes to enhance the accountability of surplus lines insurers regarding claim denials. It introduces a requirement that decisions to deny claims must be reviewed and approved by a "qualified human professional," which includes supervisors and licensed claims adjusters. The bill explicitly prohibits the use of artificial intelligence, machine learning algorithms, or automated systems as the basis for denying claims. Insurers are mandated to maintain detailed records of the human review process for denied claims and to provide specific information in denial communications to claimants. Additionally, the Office of Insurance Regulation is authorized to audit claim denials to ensure compliance with these new requirements.

The bill also amends the valued policy law to include surplus lines insurers and clarifies the definitions and responsibilities associated with insurance claims. It specifies that the term "insurer" now encompasses unauthorized insurers assuming surplus lines direct risks. The legislation aims to ensure that claim denials are made with human oversight and transparency, thereby protecting consumers and enhancing the integrity of the claims process. The effective date for these changes is set for July 1, 2025.

Statutes affected:
H 1555 Filed: 627.702, 627.7011, 627.7142