North Carolina: AI health laws

Bulletin 24-B-19, The Use of Artificial Intelligence Systems in Insurance

Tells insurers that decisions and actions affecting consumers that are made or supported by AI systems, including claim management and payment, must comply with insurance law, including the unfair and deceptive trade practice provisions of Article 63 of Chapter 58, and sets expectations for a written AI systems program covering governance, risk management, internal controls and third-party AI systems, which the Department of Insurance may review in investigations and examinations.

Physician read. It places no duty on physicians. Since Dec. 18, 2024, the Department of Insurance has told insurers, including health insurers, that claim and coverage decisions made or supported by AI must meet North Carolina's unfair trade practice laws, and it may examine how they govern those systems.

Applies to: All insurers licensed to do business in North Carolina, including health insurers

Notes: North Carolina's version of the NAIC Model Bulletin: it follows the model's four sections (introduction and authority, definitions, regulatory guidance and expectations, regulatory oversight and examination), and the NAIC's adoption map lists it as adopted Dec. 18, 2024. Signed by Commissioner of Insurance Mike Causey and addressed to all insurers licensed in the state. The bulletin states no separate effective date; the issue date is used.