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Florida lawmakers target AI in insurance claim denials
Florida lawmakers target AI in insurance claim denials

CBS News

time25-03-2025

  • Health
  • CBS News

Florida lawmakers target AI in insurance claim denials

A Florida Senate committee has approved a bill that would prevent insurers from using artificial intelligence as the sole basis for denying claims, with the proposal saying decisions should be made by a "qualified human professional," The Senate Banking and Insurance Committee unanimously backed the proposal, which comes as other states also have looked at the use of artificial intelligence in insurance decisions. "We want to make sure that we strike the right balance between allowing innovation but also protecting consumers from unaccountable algorithms," bill sponsor Jennifer Bradley said. The bill would place a series of requirements on insurers, including saying that a decision "to deny a claim or any portion of a claim must be made by a qualified human professional." Such people would have to analyze claims and the insurance policies and "review the accuracy of any output generated" by an artificial intelligence system, machine learning system or algorithm. "An algorithm, an artificial intelligence system or a machine learning system may not serve as the sole basis for determining whether to adjust or deny a claim," the bill says. A Senate staff analysis said other states, the U.S. Department of Health and Human Services and the National Association of Insurance Commissioners in recent years have sought to address the use of algorithms and artificial intelligence in insurance decisions. As an example, the analysis said California last year passed a measure that seeks to ensure decisions about medical care are made by health-care providers and not solely by artificial intelligence used by insurers. The analysis also said lawsuits were filed during the past three years in California and Minnesota involving allegations about health insurers using artificial intelligence to screen claims or deny coverage. While Bradley's bill drew little discussion on Tuesday, the Florida Medical Association, which represents physicians and sometimes tangles with insurers, indicated its support. Bradley said she has had discussions with insurers to resolve issues about the bill. "While AI can improve efficiency and accuracy in certain cases, the bill seeks to mitigate risks related to potential inaccuracies and biases," she said. "It highlights the importance of human judgment and decisions, ensuring technology supplements rather than replaces critical human oversight." The bill would need approval from two more committees before it could go to the full Senate. Republican Rep. Hillary Cassel, of Dania Beach, has filed a broader House insurance bill that would require human reviews of claim denials. That bill has not been heard in committees.

Condominium hurricane hardening pilot could become more accessible
Condominium hurricane hardening pilot could become more accessible

Yahoo

time03-03-2025

  • Business
  • Yahoo

Condominium hurricane hardening pilot could become more accessible

Vantage Point Condominiums in St Petersburg. (Photo by Mitch Perry/Florida Phoenix) Condominium associations would no longer need unanimous approval from unit owners to qualify for a pilot grant program intended to make the buildings more resistant against hurricanes under a bill from St. Augustine Republican Sen. Tom Leek. The bill, SB 592, changes the requirements for the My Safe Florida Condominium Pilot Program lawmakers unanimously approved last year, devoting $30 million to it for the 2024-2025 fiscal year. The senator's proposal won bipartisan support in its first hearing Monday before the Senate Banking and Insurance Committee. Although no condos have received the available matching grants of up to $175,000, the state has approved qualifying inspections for 165, according to a Jan. 30 report from the Florida Department of Financial Services. The pilot program pays for the inspections. Leek's bill would allow condos to apply for the grants with the approval of at least 75% of owners who live in the units. Democratic Sen. Jason Pizzo, who co-introduced the pilot program in 2024, thanked Leek for his proposed changes. 'As you can imagine, it's nearly impossible to get 100% approval from ownership in these associations, or even at your own family dinner table sometimes. So I think it's a great start to go to 75%, but still be mindful that a lot of these associations' boards can take out tens of millions of dollars in loans, larger amounts of money, with a lot less scrutiny and threshold,' Pizzo said. Only condo buildings with at least three stories with at least one residential unit would be eligible under the changes for the wind mitigation pilot program, and the grants could only cover improvements that would result in an insurance rate or discount. Already, the pilot is limited to structures within 15 miles of the coast. SUPPORT: YOU MAKE OUR WORK POSSIBLE

DeSantis seeks $590 million for My Safe Florida Home grant program; would cover 45,000 on waiting list
DeSantis seeks $590 million for My Safe Florida Home grant program; would cover 45,000 on waiting list

Yahoo

time08-02-2025

  • Business
  • Yahoo

DeSantis seeks $590 million for My Safe Florida Home grant program; would cover 45,000 on waiting list

Who knew? A lot of Floridians, it turns out, would like some free government money to harden their homes. Since the state's My Safe Florida Home grant program was revived in 2022, about 29,000 homeowners have received up to $10,000 each to strengthen or replace their roofs or to install impact-resistant doors, windows or storm shutters. But the application portal has been closed since July 17 of last year, leaving about 45,000 applicants on a waiting list after undergoing free windstorm mitigation inspections. Gov. Ron DeSantis is asking the state Legislature to fund grants to clear that waiting list so fresh applicants can line up this year. Business | Insurance regulators slash Citizens' requested rate hikes for 2025 Business | Citizens Insurance rates to decrease in South Florida, DeSantis reveals Business | Asphalt shingle roofs begin to lose wind resistance after only 10 years, state officials say DeSantis' 2025-26 budget request seeks $590 million in additional funding for the popular program. If approved, it would be the largest single-year outlay since the program was revived. Of the total, $480 million would be earmarked for homeowners on the waiting list and another $109 million would fund grants for 10,000 new applicants. An annual recurring outlay of about $100 million would fund about 10,000 new grants each year. DeSantis promoted the program during a news conference touting the state's actions to shore up the insurance market. He said he wanted lawmakers to enact funding to cover homeowners on the waiting list during the special legislative session that he ordered to begin on Jan. 27. Lawmakers instead called their own session focused on immigration reform. 'Anyone that's on the waiting list, we wanted to get that funded so that they can make improvements to their home in time for this coming hurricane season,' he said. Introduced late in the first decade of the 2000s, the program was revived in 2022 as part of a series of insurance reforms that aimed to reduce litigation — and insurance company failures. State leaders argued that improving the resiliency of homes against hurricanes would likely help homeowners secure a lower insurance premium while reducing insurance losses reported after storms. About half of grant recipients since 2022 have so far reported seeing a lower insurance premium, Steven Fielder, the program's director, recently told the Senate Banking and Insurance Committee. Unless laws enacted last year are revised, it's questionable whether future applicants will be able to get approved unless their households qualify as earning a low or moderate income. When the program was originally revived in 2022, it accepted applications from homeowners without regard to income level or age. The laws that were added last year set aside 60 days for applicants with low and moderate incomes to apply for grants before anyone else. In addition, the maximum grant a low-income applicant can get without having to show they paid $1 for every $2 sought from the program was increased from $5,000 to $10,000. Low-income households are defined as making 80% or less than the median household income of their county. Moderate-income households are defined as making 120% or less of their county's median household income. The median income is determined by the federal Department of Housing and Urban Development and varies by county and household size. As evidenced by the 3,316 homeowners who applied during the first 17 days after the program reopened on July 1, funding for the 10,000 open slots is likely to be obligated before the age and income level restrictions for applications expire. The Legislature is expected to consider the governor's request sometime during the legislative session that begins March 4. Anyone who made it through the complicated application process, got someone on the phone to answer questions, selected a contractor to do the work, secured an approval for a grant, oversaw completion of the work, ordered a reinspection to verify that the work was done, and secured their grant should consider themselves one of the lucky ones. Of 109,464 homeowners who have applied to the program since 2022, about 54% — 58,792 — have been approved for a grant. Only about half of those — 29,000 — have received their grant. Of the state's 67 counties, grant activity remains highest in Broward County (9,722 obligated grants, 7,548 on waiting list) and Palm Beach County (7,844 obligated grants, 6,272 on waiting list). Pinellas and Miami-Dade counties are third and fourth on both lists. Brevard County topped the list of obligated grants in Central Florida with 3,544, followed by Volusia (1,359), Orange (1,356), Seminole (685), Lake (287), and Osceola (264). Brevard also topped the waiting list with 2,751, followed by Orange (1,498), Volusia (1,226), Seminole (734), Lake (311) and Osceola (292). DeSantis also asked for another $30 million to continue a pilot program, My Safe Florida Condominium, that would provide up to $175,000 to help condo associations harden their buildings. That program was launched on Nov. 14. Applications were open just five days with 165 applicants. Because the program opened only recently, none of the associations have requested their grant money yet, said Devin Galetta, program spokesman. Ron Hurtibise covers business and consumer issues for the South Florida Sun Sentinel. He can be reached by phone at 954-356-4071 or by email at rhurtibise@

Asphalt shingle roofs begin to lose wind resistance after only 10 years, state officials say
Asphalt shingle roofs begin to lose wind resistance after only 10 years, state officials say

Yahoo

time04-02-2025

  • Automotive
  • Yahoo

Asphalt shingle roofs begin to lose wind resistance after only 10 years, state officials say

Asphalt shingle roofs only provide full protection against hurricane winds until they are 10 years old, state officials told a panel of lawmakers on Tuesday. After they hit 10 years, degradation from the sun will weaken the shingles, which are petroleum based, to the point where they offer less and less protection, the officials said at a hearing of the Senate Banking and Insurance Committee. Insurance Commissioner Michael Yaworsky expanded on the topic of asphalt shingle roofs that he first raised late last year when he said that they don't last for 30 years in the state as some manufacturers claim. 'Maybe it's time to start writing them out of the plot in Florida,' Yaworsky told the Florida Chamber's annual Insurance Summit in December. Politics | 'Citizens insurance for all' among insurance proposals filed for spring legislative session Politics | New property insurer approved for Florida, plans 81,040 Citizens takeouts Politics | Find out the average price of home insurance in your county, and how much it increased since 2022 On Tuesday, Yaworsky revealed that a report completed in June by Applied Research Associates Inc. — citing tests by the Insurance Institute for Business & Home Safety and other organizations — found that the average life of a roof 'where it has that real hurricane cat(astrophe) resistance is 10 years.' He continued, 'And then it begins to fall off in its ability to be resilient against catastrophic risk.' The Applied Research Associates report, based on observations of damage from hurricanes Ian, Michael and Irma, found that 'older asphalt shingles exhibit poorer performance compared to relatively new ones.' Nearly half of all shingle roofs exhibited 'detectable damage, suggesting minimal advancement in wind resistance since Hurricane Charley in 2004.' As asphalt shingle roofs age, the report said, they become more susceptible to 'cohesion failure' in the underlying sealant, which leaves the roof vulnerable to wind uplift forces. Shingles over six years old 'exhibit higher failure probabilities compared to those without the roof aging effect.' Mike Silvers, director of technical services for the Florida Roofing and Sheet Metal Contractors Association, defended asphalt shingle roofs when contacted by the South Florida Sun Sentinel in December. He said that higher quality asphalt shingles installed under today's Florida Building Code are more likely to withstand hurricane-force winds with minimal damage. While asphalt shingle roofs — the least expensive roof type in place on an estimated 65% of Florida homes — will be around for decades, Yaworsky said, 'that doesn't mean there shouldn't be incentivization in moving toward more resilient roof types over the course of generations and decades.' He said a revised version of the form that spells out home-hardening improvements that can earn Florida homeowner insurance discounts will include a specific discount for metal roofs, considered the strongest and longest lasting of roof options. That doesn't mean metal roofs are right for everyone, he said. Homeowners must weigh the economics of making the investment. Typically, metal roofs cost two to three times more than a shingle roof. While they can save homeowners money by lasting 30 to 50 years, they can also offset insurance savings by increasing the total insured value of the home, he said. Yaworsky said that composite tile roofing materials are entering the market as another option that holds promise. Extensive testing of products that are in the field must be completed to 'actually see how they hold up against real-world conditions,' he said. 'If there is one good thing in the tragedies that have befallen the state in the past decade with the (hurricane) events we've had, it's given us really, really good data,' he said. Michael Newman, general counsel for Insurance Institute for Business & Home Safety, spelled out differing impacts of specific wind speeds on 10-year-old asphalt shingle roofs: — A 10-year-old roof has a one-in-12 chance of damage from 60 mph winds. — That chance goes up to 25% against a 90 mph wind. — Against 100 mph winds, the chance of damage rises to 'nearly 100%.' Those probabilities apply generally to all classes of asphalt shingle roofs and not to those with specific features or construction types, he said. While sealed roof decks are required for newly constructed homes, 'if that is missing, up to nine bathtubs of water can pour into the home from a single inch of rain,' Newman said. Such a flood, he added, would destroy contents, trigger mold remediation, and lead to a 'significant insurance claim.' Testing of resiliency of roof types isn't intended to separate 'good from bad,' he said. Rather, 'it's about what are the appropriate expectations of consumers and insurers about how long particular roof types will last.' Hurricanes aren't the only type of catastrophe that metal roofs can help homeowners avoid, said Kevin Guthrie, executive director of Florida's Division of Emergency Management. Guthrie said metal roofs also provide greater protection against wildfires. After the 'Chipola Complex' fires in the state's Big Bend region in March 2022, investigators noticed that homes with metal roofs were less likely to catch fire, providing firefighters with an extra 10 to 30 minutes to respond. Sen. Rosalind Osgood, a Democrat representing central west Broward County, asked when she should plan to replace her roof. Yaworsky said that depends because the life of a roof can vary depending on 'individually tailored' variables. He said that homeowners should consult their insurance agents and hire a qualified inspector 'to look at that roof and see how much life is left in it.' Sen. Blaise Ingoglia, chairman of the committee, scolded unnamed 'roofing supply companies' for marketing dimensional shingles as lasting 30 to 40 years. 'In the state of Florida,' he said, 'you're lucky if you get it to last, 12, 13 or 15 years because of the sun. Because it is a petroleum product, it's melting and disintegrating. I mean, if you've ever been on a roof, tearing off old shingles, they basically come off like paper at that point. You can literally tear them.' Ron Hurtibise covers business and consumer issues for the South Florida Sun Sentinel. He can be reached by phone at 954-356-4071 or by email at rhurtibise@

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