Florida HB 527: Visiting County and Municipal Detention Facilities

Bill Text

CS/CS/HB 527 2026

CODING: Words stricken are deletions; words underlined are additions.
hb527-02-c2
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

A bill to be entitled 1
An act relating to mandatory human reviews of 2
insurance claim denials; creating s. 440.131, F.S.; 3
defining terms; authorizing workers' compensation 4
carriers to use artificial intelligence systems and 5
machine learning systems to assist in processing 6
claims; prohibiting the use of artificial intelligence 7
or machine learning systems as the sole basis for 8
determining whether to reduce a claim payment or deny 9
a claim or portion of a claim; requiring that 10
carriers' decisions to deny a claim or portion of a 11
claim or reduce a claim be made by qualified human 12
professionals; specifying the duties of qualified 13
human professionals; requiring a carrier to maintain 14
certain records; requiring carriers to include certain 15
information in denial communications to claimants; 16
requiring that certain carriers detail certain 17
information in their claims-handling manual; 18
authorizing the Department of Financial Services to 19
conduct examinations and investigations under certain 20
circumstances and to adopt rules; providing penalties; 21
creating s. 627.4263, F.S.; defining terms; 22
authorizing insurers to use artificial intelligence 23
systems and machine learning systems to assist in 24
processing claims; prohibiting the use of artificial 25

CS/CS/HB 527 2026

CODING: Words stricken are deletions; words underlined are additions.
hb527-02-c2
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

intelligence or machine learning systems as the sole 26
basis for determining whether to reduce a claim 27
payment or deny a claim or portion of a claim; 28
requiring that insurers' decisions to deny a claim or 29
portion of a claim or reduce a claim be made by 30
qualified human professionals; specifying the duties 31
of qualified human professionals; requiring an insurer 32
to maintain certain records; requiring insurers to 33
include certain information in denial communications 34
to claimants; requiring that certain insurers detail 35
certain information in their claims-handling manual; 36
authorizing the Office of Insurance Regulation to 37
conduct market conduct examinations and investigations 38
under certain circumstances; authorizing the Financial 39
Services Commission to adopt rules; creating s. 40
641.31091, F.S.; defining terms; authorizing health 41
maintenance organizations to use artificial 42
intelligence systems and machine learning systems to 43
assist in processing claims; prohibiting the use of 44
artificial intelligence or machine learning systems as 45
the sole basis for determining whether to reduce a 46
claim payment or deny a claim or portion of a claim; 47
requiring that health maintenance organizations' 48
decisions to deny a claim or reduce a claim or portion 49
of a claim be made by qualified human professionals; 50

CS/CS/HB 527 2026

CODING: Words stricken are deletions; words underlined are additions.
hb527-02-c2
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

specifying the duties of qualified human 51
professionals; requiring a health maintenance 52
organization to maintain certain records; requiring 53
health maintenance organizations to include certain 54
information in denial communications to claimants; 55
requiring that certain health maintenance 56
organizations detail certain information in their 57
claims-handling manual; authorizing the office to 58
conduct market conduct examinations and investigations 59
under certain circumstances; authorizing the 60
commission to adopt rules; providing an effective 61
date. 62
63
Be It Enacted by the Legislature of the State of Florida: 64
65
Section 1. Section 440.131, Florida Statutes, is created 66
to read: 67
440.131 Mandatory human reviews of claim denials.— 68
(1) As used in this section, the term: 69
(a) "Artificial intelligence system" means a machine-based 70
system that may have varying levels of autonomy and that can, 71
for a given set of objectives, generate outputs, such as 72
predictions, recommendations, or content, influencing decisions 73
made in real or virtual environments. 74
(b) "Machine learning system" means an artificial 75

CS/CS/HB 527 2026

CODING: Words stricken are deletions; words underlined are additions.
hb527-02-c2
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

intelligence system that has the ability to learn from provided 76
data without being explicitly programmed. 77
(c) "Qualified human professional" means an individual 78
who, under the Florida Insurance Code, has the authority to 79
adjust or deny a claim or a portion of a claim and may exercise 80
such authority over a particular claim. 81
(2) A carrier may use an artificial intelligence system or 82
a machine learning system to assist in processing claims, 83
includ