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Consumer behavior and in particular consumer decision making is key to successful marketing strategies. The insurance industry is no exception in this regard. Consumers employ different decision making strategies to make an insurance decision - be it for or against a certain insurance policy, whether to rely on external advice or decide alone, or whether to entrust the own safety to a new player in the industry. The aim of this dissertation is to look at consumer decision making strategies from different perspectives. By doing so, this work contributes to both academia and practice, so that they can develop a better understanding of what benefits and harms consumers when making an insurance decision. The dissertation spans over five parts. Part I frames the overall goals of the research by giving an overview of the state of the art in the field and highlighting the contributions to theory and practice. Part II and III focus on how consumers can be protected as participants in the insurance marketplace based on their current behavioral patterns. The fourth part researches intangible sharing services and empirically investigates why consumers participate in them. The last part conceptualizes the actors and relationships that shape the essence of collaborative consumption, a trend in consumer exchange markets that has found its way to the insurance industry.
Considerable evidence suggests that many people for whom insurance is worth purchasing do not have coverage and others who appear not to need financial protection against certain events actually have purchased coverage. There are certain types of events for which one might expect to see insurance widely marketed are now viewed today by insurers as uninsurable and there are other policies one might not expect to be successfully marketed that exist on a relatively large scale. In addition, evidence suggests that cost-effective preventive measures are sometimes rewarded by insurers in ways that could change their clients' behavior. These examples reveal that insurance purchasing and marketing activities do not always produce results that are in the best interest of individuals at risk. Insurance Decision Making and Market Behavior discusses such behavior with the intent of categorizing these insurance "anomalies". It represents a first step in constructing a theory of insurance decision making to explain behavior that does not conform to standard economic models of choice and decision-making. Finally, the authors propose a set of prescriptive solutions for improving insurance decision-making.
This book examines the behavior of individuals at risk and insurance industry policy makers involved in selling, buying and regulation.
ABSTRACT: In addition to consumer decision-making, I also examine decision-making from the perspective of the insurer. Separate streams of empirical research suggest that firms may make adjustments toward a target capital structure, and that active internal capital markets (ICMs) exist within a variety of industries. While evidence supports the existence of targeting behavior on behalf of firm management and the existence of ICMs, no studies have examined how deviations from target capital structure relate to the use of ICMs. Based on a sample of affiliated property-casualty insurance companies and three commonly used measures of leverage, this study provides the first evidence of a link between deviations from target leverage and ICM activity. The findings suggest that affiliated property-casualty insurers do have target leverage ratios and that ICM activity is related to deviations from target leverage, where overleveraged insurers tend to cede more internal reinsurance and underleveraged insurers tend to cede less internal reinsurance.
"This book examines the behavior of individuals at risk, insurance industry decision makers and policy makers involved in the selling, buying, and regulating of insurance"--
As individuals, we face the challenge of making numerous decisions every day. Although some of them are made consciously, the majority are made unconsciously and automatically (Pöppel, 2007, p. 22). Especially in the insurance sector, which is one of the more complex fields of decisionmaking, these decisions have far-reaching significance. The discussion of risk protection and individual insurance demand is gaining in importance, especially against the backdrop of climate change, cyber-attacks and global health crises such as the COVID 19 pandemic. The literature research in the context of these interests revealed that studies and surveys in Germany, Europe, as well as in North America repeatedly identify structural insurance gaps and a tendency towards underinsurance. This reveals systematic deviations from economically appropriate insurance coverage. There is even talk of “misinsurance” due to incorrect risk perception, assessment, and evaluation on the part of the policyholders. From a behavioural economics perspective, these patterns can be attributed to heuristics and cognitive biases that influence the decision-making of the insured (European Commission, 2017; GDV, 2020; GoslarInstitut, 2016, Kunreuther et al., 2013, Richter et al., 2019). Based on these findings, the commercial insurance coverage of doctors in private practice was evaluated and the demand for insurance was investigated. Officed- based doctors in Germany are central actors in the health care system and so far, there is no specific study on their coverage behaviour. The aim of the thesis was therefore to examine the officed- based doctors’ behaviours towards professional safe-guarding risks. With a further objective to investigate the use of heuristics and identify factors indicating deviations from economically adequate insurance coverage, to better understand manifested decision-making behaviour.
Following the implementation of the Affordable Care Act (ACA), millions of Americans have gained coverage, many for the first time in their lives. The law has created more options for affordable coverage and put millions into the driver seat when it comes to selecting their coverage and enrolling in a health plan. The individual health insurance market has undergone significant changes under the ACA, including the creation of state-based and federally facilitated marketplaces where individuals in all states can go to shop for and enroll in potentially subsidized individual market coverage. This dissertation seeks to improve our understanding of consumer decision-making in this new health insurance landscape. Through three sets of analyses of consumer behavior during the insurance decision-making process, this dissertation will provide needed updates to the literature on this topic. It also highlights key considerations for policymakers and agencies to weigh when evaluating how consumers might respond to policies that change their available coverage options. The first paper examines two key components of health plans that individuals weigh when making enrollment decisions - cost and quality. The ACA requires both federally facilitated and state-based marketplaces to provide easy to understand plan quality information to customers shopping for coverage. Through two hypothetical choice experiments, this paper examines how consumers weighed health plan costs and quality in different choice environments and explored the consumer characteristics associated with a preference for high quality plans as well as with the selection of inferior plans. In each experiment, participants responded to a series of choice scenarios that asked them to choose between five health plans that differed only in their costs and quality ratings, represented by stars. Overall, between scenarios individuals were willing to pay more for higher quality plans when the quality ratings of all available plans were lower, when the higher quality plan's rating was two stars higher rather than one star higher than other plans, and when the price differential was lower. More risk averse participants had higher predicted probabilities of consistently choosing the higher quality, more expensive plan. However, a significant portion of the study population made poor decisions: more than a third of participants chose a dominated plan at least once. The less numerate, those with higher risk-seeking tendencies, and those with low health insurance literacy had the highest predicted probabilities of choosing poorly. The second experiment also found that individuals are more likely to choose a dominated plan when the quality star ratings are similar across plans. The second and third papers use data from California's health insurance marketplace, Covered California, to examine consumer behavior following the implementation of silver loading in 2018. Silver loading is a policy California and other states put into place after the cancellation of federal funding for a set of subsidies included in the ACA that reduce the amount of cost-sharing required by low-income enrollees in silver tier marketplace plans, known as cost-sharing reductions (CSRs). Silver loading placed the cost of providing CSRs in the absence of federal funding onto the premiums of silver plans, subsequently raising premium subsidies which are tied to the cost of silver coverage. The second paper focuses on enrollment in silver plans that became dominated because of silver loading. This paper looks at enrollment in these plans over time (both before and after they became dominated) and by enrollees' prior year enrollment decisions to examine differences in enrollment by pre-existing biases regarding metal tier labeling and the potential role of status quo bias. Overall, more than 60,000 Californians enrolled in a dominated plan in 2018 and, on average, households enrolled in dominated plans in 2018 spent an additional $38.87 per month in premiums. Households that were enrolled in silver coverage in the year before the examined silver plans became dominated had the highest predicted probability of enrolling in a dominated plan in 2018. The third paper examines Covered California consumers' decisions to switch health plans during open enrollment over the first four open enrollment periods where individuals could renew their coverage (2015-2018). Under the ACA, switching rates in the individual market have been much higher than those previously seen in other markets. Looking at re-enrollees in Covered California, this paper provides data on consumer switching behavior over time and identifies the consumer, plan, and choice environment characteristics associated with consumers' decisions to change their coverage during open enrollment. The percentage of re-enrollees in Covered California who made changes to their coverage steadily increased between the 2014-15 and 2017-18 open enrollment periods. Following the implementation of silver loading the proportion of consumers who moved into gold plans during the 2017-18 open enrollment period drastically increased, compared to previous years. Among bronze or silver plan enrollees who switched metal tiers during open enrollment, those who could enroll in gold plans that were no more than $49 per month more expensive than their initial bronze or silver plan had a significantly higher probability of switching into gold coverage than those who faced larger premium differences. The results of this dissertation identify several consumer, health plan, and choice environment characteristics that can influence consumer health insurance decision-making. Policymakers and marketplace regulators can use this work to help inform the decisions they make around marketplace choice architecture, policies aimed at retaining enrollees and recruiting new consumers, and decisions about re-enrollment for consumers who do not actively renew their coverage during annual re-enrollment periods.
The direct-to-consumer business model has transformed how people seek out goods and services from music to mortgages. So what happens now that the revolution has come for healthcare? While consumers have begun to insist on healthcare that is as convenient and personalized as nearly every other good or service they purchase, most healthcare provider organizations, physicians, and insurance companies remain woefully unprepared to meet this demand. Choice Matters is the healthcare sector's guide to understanding and delivering the brand of consumer-centered care that is an imperative for the Zocdoc age. Drawing on the authors' diverse backgrounds in medicine, business, and public policy, this practically-oriented resource offers an on-the-ground introduction for clinicians and managers to better understand: · The differences between healthcare and other consumer-driven markets · What factors are most important for consumers in seeking care providers · How consumers make decisions about healthcare · The system-wide effects of increased consumer choice in healthcare · The important distinction between patients and consumers By celebrating the possibilities inherent to consumer-centered healthcare, Choice Matters offers a refreshing, empirically informed take on how healthcare in the United States can flourish, not wither, in the new economy.
The challenge of responding effectively to rapidly changing consumer needs and behaviors is recognized as one of the top strategic agenda items. We set out to obtain hard evidence of customer attitudes and behaviors. We undertook a worldwide insurance customer survey -- unprecedented in both its scope and scale -- to explore what drives consumer behavior across he whole customer life cycle and to test some of the received wisdom held in the industry today; to separate myth from reality, if you will. Our research reveals that while, of course, there are significant variations in customer attitudes and behaviors around the globe, there are some underlying themes that are remarkably consistent. Our findings also clearly show that insurers are far behind other sectors in meeting consumers' expectations. So how should insurers respond? They undoubtedly need to rethink their approach to customers and seek to implement a tailored, yet lower-cost “customer-centric” operating model to support it better. Insurers will need to define what it means to be customer-centric and develop critical new competencies, aligning their operating models accordingly. Significantly, although the above activities may be considered transformational to many in the industry, we believe they will only provide insurers with the ability to catch up and otherwise “protect the core.” To leapfrog competitors and generate significant growth requires true customer-centric innovation and a significant change in approach to strategic decision-making. Implementing these strategies will future-proof the core business, while allowing insurers to redefine customer relationships and become a different insurer -- the insurer of the future.
Two related trends have created novel challenges for managing risk in the United States. The first trend is a series of dramatic changes in liability law as tort law has expanded to assign liability to defendants for reasons other than negligence. The unpredictability of future costs induced by changes in tort law may be partly responsible for the second major trend known as the `liability crisis' - the disappearance of liability protection in markets for particularly unpredictable risks. This book examines decisions people make about insurance and liability. An understanding of such decision making may help explain why the insurance crisis resulted from the new interpretations of tort law and what to do about it. The articles cover three kinds of decisions: consumer decisions to purchase insurance; insurer decisions about coverage they offer; and the decisions of the public about the liability rules they prefer, which are reflected in legislation and regulation. For each of these three kinds of decisions, normative theories such as expected utility theory can be used as benchmarks against which actual decisions are judged.