Who is Changing Health Insurance Coverage? Empirical Evidence on Policyholder Dynamics
Open accessAbstract
Long‐term health insurance contracts provide policyholders with the option of lapsing coverage or switching to another tariff within the same insurance company. We empirically analyze policyholder behavior regarding contract commitment in a large data set of German private health insurance contracts. We show that short‐term as well as long‐term premium development, along with premium adjustment frequency, affect lapse and tariff switch rates. Moreover, the sales channel has a strong impact on switching behavior, indicating that policyholder choice is not fully independent of sales representatives. Our results are important for risk assessment and risk management of portfolios of health insurance contracts and provide better understanding of the dynamics of policyholder behavior in health insurance.
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Intense competition in the health insurance segment leads customers to switch service providers.
“However, the intense competition in the health insurance segment is of great concern for any insurance player as it leads to customer’s switching service providers (Christiansen et al. 2016; Dominique-Ferreira 2017).”
From Health insurance policy renewal: an exploration of reputation, performance, and affect to understand customer inertia (2022) · cites this paper as Christiansen et al. 2016
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Cites
Nelder, J. A., & Wedderburn, R. W. M. (1972) · Journal of the Royal Statistical Society Series A (General) · doi:10.2307/2344614 · Cited by 7,321 · see citing works
Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information
Rothschild, M., & Stiglitz, J. (1976) · The Quarterly Journal of Economics · doi:10.2307/1885326 · Cited by 4,987 · see citing works
Specification Tests for the Multinomial Logit Model
Hausman, J. A., & McFadden, D. L. (1984) · Econometrica · doi:10.2307/1910997 · Cited by 2,542 · see citing works
Structural analysis of discrete data with econometric applications
Grether, D. M. (1982) · Journal of Mathematical Psychology · doi:10.1016/0022-2496(82)90042-6 · Cited by 1,928 · see citing works
Econometric Models of Probabilistic Choice
McFadden, D. L. (1981) · Medical Entomology and Zoology · Cited by 1,832 · see citing works
Hausman, J. A., & Wise, D. A. (1978) · Econometrica · doi:10.2307/1913909 · Cited by 926 · see citing works
Chapter 11 The anatomy of health insurance
Cutler, D., & Zeckhauser, R. (2000) · Handbook of health economics · doi:10.1016/s1574-0064(00)80170-5 · Cited by 654 · see citing works
Paying for Health Insurance: The Trade-Off between Competition and Adverse Selection
Cutler, D., & Reber, S. (1998) · The Quarterly Journal of Economics · doi:10.1162/003355398555649 · Cited by 614 · see citing works
Morin, R. A., & Suarez, A. (1983) · The Journal of Finance · doi:10.1111/j.1540-6261.1983.tb02291.x · Cited by 340 · see citing works
Morin, R. A., & Suarez, A. (1983) · The Journal of Finance · doi:10.2307/2328020 · Cited by 266 · see citing works
Switching costs, price sensitivity and health plan choice
Strombom, B. A., Buchmueller, T. C., & Feldstein, P. J. (2002) · Journal of Health Economics · doi:10.1016/s0167-6296(01)00124-2 · Cited by 261 · see citing works
The Role of Commitment in Dynamic Contracts: Evidence from Life Insurance
Hendel, I. E., & Lizzeri, A. (2003) · The Quarterly Journal of Economics · doi:10.1162/00335530360535216 · Cited by 256 · see citing works
Time-Consistent Health Insurance
Cochrane, J. H. (1995) · Journal of Political Economy · doi:10.1086/261991 · Cited by 226 · see citing works
Viaene, S., Derrig, R. A., Baesens, B., & Dedene, G. (2002) · Journal of Risk & Insurance · doi:10.1111/1539-6975.00023 · Cited by 223 · see citing works
The effect of price on switching among health plans
Buchmueller, T. C., & Feldstein, P. J. (1997) · Journal of Health Economics · doi:10.1016/s0167-6296(96)00531-0 · Cited by 176 · see citing works
The Demand for Employment-Based Health Insurance Plans
Feldman, R. D., Finch, M. D., Dowd, B. E., & Cassou, S. P. (1989) · The Journal of Human Resources · doi:10.2307/145935 · Cited by 158 · see citing works
An Empirical Study on the Lapse Rate: The Cointegration Approach
Kuo, W., Tsai, C., & Chen, W. (2003) · Journal of Risk & Insurance · doi:10.1111/1539-6975.t01-1-00061 · Cited by 148 · see citing works
Guaranteed renewability in insurance
Pauly, M. V., Kunreuther, H. C., & Hirth, R. A. (1995) · Journal of Risk and Uncertainty · doi:10.1007/bf01083557 · Cited by 117 · see citing works
Consumer Health Plan Choice: Current Knowledge and Future Directions
Scanlon, D. P., Chernew, M. E., & Lave, J. R. (1997) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.18.1.507 · Cited by 113 · see citing works
Housing, Health, and Annuities
Davidoff, T. (2009) · Journal of Risk & Insurance · doi:10.1111/j.1539-6975.2009.01287.x · Cited by 100 · see citing works
What Policy Features Determine Life Insurance Lapse? An Analysis of the German Market
Eling, M., & Kiesenbauer, D. (2014) · Journal of Risk and Insurance · doi:10.1111/j.1539-6975.2012.01504.x · Cited by 81 · see citing works
Self-citationAdverse Selection and Adverse Retention
Cutler, D., Altman, D., & Zeckhauser, R. (1998) · American Economic Review · Cited by 69 · see citing works
Preferences and choices for care and health insurance
van den Berg, B., van Dommelen, P., Stam, P., et al. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.02.021 · Cited by 60 · see citing works
The Quality of Insurance Intermediary Services—Empirical Evidence for Germany
Eckardt, M., & Räthke‐Döppner, S. (2010) · Journal of Risk & Insurance · doi:10.1111/j.1539-6975.2010.01361.x · Cited by 59 · see citing works
Hofmann, A., & Browne, M. J. (2013) · Journal of Risk and Uncertainty · doi:10.1007/s11166-012-9160-6 · Cited by 51 · see citing works
Contracting with Limited Commitment: Evidence from Employment-Based Health Insurance Contracts
Crocker, K. J., & Moran, J. R. (2003) · The RAND Journal of Economics · doi:10.2307/1593784 · Cited by 44 · see citing works
Commitment and Lapse Behavior in Long‐Term Insurance: A Case Study
Pinquet, J., Guillén, M., & Ayuso, M. (2011) · Journal of Risk & Insurance · doi:10.1111/j.1539-6975.2011.01420.x · Cited by 42 · see citing works
Hoffman, S. D., & Duncan, G. J. (1988) · The Journal of Human Resources · doi:10.2307/145813 · Cited by 40 · see citing works
Trigo-Gamarra, L. (2008) · The Geneva Papers on Risk and Insurance Issues and Practice · doi:10.1057/gpp.2008.16 · Cited by 27 · see citing works
Transferable Ageing Provisions in Individual Health Insurance Contracts
Baumann, F., Meier, V., & Werding, M. (2008) · German Economic Review · doi:10.1111/j.1468-0475.2008.00434.x · Cited by 26 · see citing works
Selection stories: Understanding movement across health plans
Cutler, D., Lincoln, B., & Zeckhauser, R. (2010) · Journal of Health Economics · doi:10.1016/j.jhealeco.2010.08.001 · Cited by 24 · see citing works
Employee responses to health insurance premium increases.
Goldman, D. P., Leibowitz, A. A., & Robalino, D. A. (2004) · PubMed · Cited by 18 · see citing works
Death Spiral or Euthanasia? The Demise of Generous Group Health Insurance Coverage
Pauly, M. V., Mitchell, O. S., & Zeng, Y. (2004) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.3386/w10464 · Cited by 16 · see citing works
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Research works printed but not linked: 2
- Cutler, D. M., and R. J. Zeckhauser, 2000, The Anatomy of Health Insurance, in: A. Culyer and J. P. Newhouse, Eds., Handbook of Health Economics (Elsevier), pp. 563-643.
- Davidoff, T., 2009, Housing, Wealth, and Annuities, Journal of Risk and Insurance, 76(1): 31- 52.
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Kautish, P., Khare, A., & Sharma, R. (2022) · Journal of Marketing Analytics · doi:10.1057/s41270-021-00134-7 · Cited by 25 · see citing works
de la Llave, M. Á., López, F. A., & Angulo, A. (2019) · Scandinavian Actuarial Journal · doi:10.1080/03461238.2018.1531781 · Cited by 21 · see citing works
- Authors
- Christiansen, M. C., Eling, M., Schmidt, J., & Zirkelbach, L.
- Affiliations
- Universität Ulm (DE)
- University of St.Gallen (CH)
- Corresponding author
- Christiansen, Marcus C.
- Venue
- Journal of Risk and Insurance
- Publisher
- Wiley
- Published
- 2014-08-06
- Volume
- 83
- Issue
- 2
- Pages
- 269-300
- ISSN
- 0022-4367 (ISSN-L)
- 1539-6975
- OpenAlex
- W1804990272
- Cited by
- 22
- References
- 33
- Citations by year
- 2026: 1 · 2025: 2 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 6 · 2016: 1 · 2015: 1
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- green
- ux-tauri.unisg.ch
- Locations
- Journal of Risk & Insurance (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Alexandria (UniSG) (University of St.Gallen) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Insurance and Financial Risk Management
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Business, Management and Accounting › Accounting › Financial Literacy, Pension, Retirement Analysis
- Keywords
- health insurance coverage, policyholder behavior, lapse rate, sales channels, salespeople, private health insurance
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