Insurance and Behavioral Economics: Improving Decisions in the Most Misunderstood Industry

Insurance is an extraordinarily useful tool to manage risk. When it works as intended, it provides financial protection to individuals and a profitable business model for insurance firms and their investors. But it is broadly misunderstood by consumers, regulators, and insurance executives. This book looks at the behavior of individuals at risk, insurance industry decision makers, and policy makers at the local, state, and federal level involved in the selling, buying, and regulating of insurance. It compares their actions to those predicted by benchmark models of choice derived from classical economic theory. When actual choices stray from predictions, the behavior is considered to be anomalous. With considerable sums of money at stake, both in consumer premiums and insurance company payouts, it is important to understand the reasons for anomalous behavior. Howard Kunreuther, Mark Pauly, and Stacey McMorrow examine these anomalies through the lens of behavioral economics, which takes into account emotions, biases, and simplified decision rules. The authors then consider if and how such behavioral anomalies could be modified to improve individual and social welfare. This book is neither a defense of the insurance industry nor an attack on it. Neither is it a consumer guide to purchasing insurance, although the authors believe that consumers will benefit from the insights it contains. Rather, this book describes situations in which both public policy and the insurance industry’s collective posture need to change. This may require incentives, rules, and institutions to help reduce both inefficient and anomalous behavior, thereby encouraging behavior that will improve individual and social welfare.

Howard Kunreuther is the James G. Dinan Professor of Decision Sciences and Business and Public Policy at the Wharton School, University of Pennsylvania and co-director of the Wharton Risk Management and Decision Processes Center. He has a long-standing interest in ways that society can better manage low-probability, high-consequence events. Dr Kunreuther is a member of the World Economic Forum's Global Agenda Council on Insurance and Asset Management for 2011–12 and in 2009–10 served as co-chair of the Forum's Global Agenda Council on Leadership and Innovation for Reducing Risks from Natural Disasters. He is a Fellow of the American Association for the Advancement of Science and a Distinguished Fellow of the Society for Risk Analysis, which honored him with a Distinguished Achievement Award in 2001. Dr Kunreuther also received the 2015 Shin Research Excellence Award from the Geneva Association and the International Insurance Society (IIS), in recognition of his work on the role of public-private partnerships in mitigating and managing risks.

Mark Pauly is the Bendheim Professor in the Department of Health Care Management at the Wharton School of the University of Pennsylvania. One of the leading health economists of the United States, he is a former commissioner on the Physician Payment Review Commission and is a co-editor-in-chief of the International Journal of Health Care Finance and Economics and an associate editor of the Journal of Risk and Uncertainty. Professor Pauly has served on Institute of Medicine panels on public accountability for health insurers under Medicare and on improving the financing of vaccines. He is a former member of the advisory committee to the Agency for Health Care Research and Quality and the Medicare Technical Advisory Panel.

Stacey McMorrow is a research associate in the Health Policy Center at the Urban Institute, Washington, DC. She is currently leading a study of the effects of increased federal funding for community health centers on access to care for low-income individuals and has analyzed the potential impacts of the Affordable Care Act on small employers, individuals and families. Dr McMorrow's PhD dissertation at the University of Pennsylvania explored the market-level effects of health insurance, specifically examining the impact of a large uninsured population on the availability of specialized hospital services as well as on utilization and outcomes for Medicare beneficiaries.