Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: Artificial intelligence is no longer an emerging technology — it is rapidly becoming the core engine of risk selection, pricing, underwriting, and customer interaction across insurance and financial services. But as models evolve into autonomous agentic systems and decision pipelines become more complex, traditional guardrails are being stress-tested like never before.