Journal of Behavioral and Experimental Finance 36 (2022) 100748

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Journal of Behavioral and Experimental Finance

journal homepage: www.elsevier.com/locate/jbef

Full length article

Relationship and mutual influence between poverty and insurance in a

developing insurance market
∗
Liudmila Tsvetkova a , , Igor Okhrimenko b , Tamara Belousova b , Leonid Khuzhamov b
a
Department of Risk Management and Insurance, MGIMO University, Moscow, Russian Federation
b
Department of Insurance and Economy of Social Sphere, Financial University under the Government of the Russian Federation, Moscow, Russian
Federation

article info a b s t r a c t

Article history: The ‘‘number one’’ goal of sustainable development today is to end poverty. The creation of effective
Received 25 April 2022 methods and tools for this purpose would require a thoughtful investigation on poverty and its mutual
Received in revised form 8 August 2022 effects. The present study seeks to identify the relationships and interdependencies between the key
Accepted 24 August 2022
financial characteristics of low-income households and their propensity for insurance purchase under
Available online 29 August 2022
the scenario where the insurance product can reduce the likelihood of catastrophic expenses. The
JEL classification: study relies on the time series model to analyze statistical information from the RF Federal State
G22 Statistics Service on the average insurance premiums and the financial characteristics of households
over the period from 2000 to 2019. Based on the results of the analysis, the first hypothesis holding
Keywords:
that insurance and household income are related (H1) was refuted, whilst the second hypothesis
Poverty
that insurance is related to household savings (H2) was confirmed. The present findings will be of
Insurance
Catastrophic spending interest to the practical sector of the economy, including managers employed in insurance companies,
SDGs as a platform for designing low-income insurance products. The findings will be useful to state and
Insurance poverty municipal employers who develop poverty reduction and/or elimination measures and to academic
Insurance affordability researchers by opening up new avenues for research.
© 2022 Elsevier B.V. All rights reserved.

1. Introduction including 18.6 million people, or 12.7% of the Russian popula-

The third decade of the 21st century saw not only the ad-
vancement of technology, but also the emergence of new risks.
For instance, the spread of fundamentally new pathogens, such as
SARS-CoV-2, multiplied the risks of health loss. Numerous natural
disasters associated with global climate change, including floods,
wildfires, and hurricanes increased the likelihood of critical life,
health, and property risks associated with the impact of natural
disasters. The advancement of technology and the quickening
pace of modern life caused a significant increase in the probability
of technological risks associated with threats to life, health and
property of citizens, as well as the risk of civil liability associ-
ated with the need to fully or partially compensate for damage
caused to a third party (Johnston et al., 2020). At the same time,
unprecedented challenges imposed by the external environment,
primarily the COVID-19 pandemic and quarantine restrictions
adopted by most countries to hold it off, have provoked a sig-
nificant increase in poverty virtually everywhere in the world.
According to the World Bank, 10% of the world’s population (more
than 737 million people) live in poverty (Atamanov et al., 2020),
∗ Corresponding author.
E-mail address: tsvetkovali@rambler.ru (L. Tsvetkova).
tion. Poor households have lower disposable incomes, providing
mostly basic necessities such as food, housing, and clothing, and
are not likely to forgo basic necessities in favor of insurance, even
if buying it would reduce potential risks (Kwarteng et al., 2020).
Meanwhile, according to the World Health Organization, 808 mil-
lion people, or 11.7% of the world’s population, spend at least 10%
of their household income on health care. For 179 million people,
health care costs exceed a quarter of their household budget, and
97 million people, or 1.4% of the world’s population, fall below
the poverty line, paying for health care out of pocket (Trans-
forming Our World, 2015; World Health Organization, 2019).
Household expenditures, including catastrophic expenditures due
to non-contractual and non-health-related contingencies (traffic
accident, fire, flood, accident, death, etc.) are not to be counted.
Under these conditions, it is only natural that social demand
for modern science-based research related to solving the cyclical
problem depicted in Fig. 1 increases.
1.1. Literature review
The relationship and mutual influence between poverty and
insurance have repeatedly been the subject of academic research,
including the interdisciplinary one. The primarily reason is the

https://doi.org/10.1016/j.jbef.2022.100748
2214-6350/© 2022 Elsevier B.V. All rights reserved.
L. Tsvetkova, I. Okhrimenko, T. Belousova et al.
Fig. 1. The cyclical problem of insurance refusal by poor households.
Source: Developed by the authors.
breadth of the concept of poverty and its great social significance
(Aboagye et al., 2022; Lu and Wang, 2021). Modern scientists
support the assumption that human life involves risks, both oc-
cupational and catastrophic, that can harm one’s health, life, and
work (Koc, 2016). The ultimate idea of insurance is to protect the
insured from risks and hazards, provide guarantees, and prevent
serious implications (Aytekin and Karamaşa, 2017). Insurance
refers to a contract for financial protection where an individual,
a group of individuals or a business receive compensation for the
loss or damage sustained upon the occurrence of insured event
in exchange for an adequate consideration called as premium
(Berteji and Hammami, 2016).
Meanwhile, there is a clear trend in the insurance industry
toward social and, above all, financial inequality (Li, 2020; Liu,
2020). The reason behind this trend is that the poor have far
fewer opportunities to take out insurance against various risks
than the better-off or the middle class. The emerging private
insurance market cannot provide sufficient financial protection
and reach the people most in need of funds (Jin et al., 2016).
At the same time, the expectations of poor households re-
garding the independent settlement of claims often result in
excessive (catastrophic) costs in circumstances beyond the con-
tract (Ahmed et al., 2016). These catastrophic expenses, in turn,
can push households below the poverty line (Suresh, 2020). Thus,
insurance can play a crucial role in preventing large debts among
the poor in the event of an emergency (Ali, 2018), which can
prevent further impoverishment of poor households. That said,
previous research has shown that about 90% of the poor would
agree to pay for health insurance if they had sufficient income
(Ahmed et al., 2016; Chantarat et al., 2017; Garedew et al., 2020;
Kebede et al., 2014), and Binnendijk et al. (2013) found a direct
correlation between willingness to pay for insurance and income.
In countries where governments are unable to provide com-
pulsory health insurance or compensate its full cost, reduction
in uncompensated health care is among the major problems
(Binnendijk et al., 2013). A range of developing countries have
recently introduced a tax-financed health insurance policy for the
poor (Karan et al., 2017; Wagstaff et al., 2016). Several coun-
tries adhere to the non-profit, community-based health insurance
(CBHI) scheme in which members regularly make certain contri-
butions to the collective fund, which is later used by the low-
income population to pay for the non-affordable health services
(Binnendijk et al., 2013; Kebede et al., 2014).
Note that while government interventions aimed to solve the
problem of health insurance for low incomes have been explored
2
Journal of Behavioral and Experimental Finance 36 (2022) 100748
in the previous research (Binnendijk et al., 2013; Kebede et al.,
2014), the low-income liability insurance remains poorly studied,
even though it could help reduce the amount of catastrophic
expenses among poor households. Some researchers wrote about
challenges that occur with this type of insurance being adopted
for motorists, including those associated with the pricing policy
regulation process (Chatzipanagiotis and Leloudas, 2020; Par-
chomovsky and Siegelman, 2020; Śliwiński and Kuryłowic, 2020).
Other types of liability insurance designed for protecting poor
households have not been sufficiently investigated.
Another strategy to fight poverty implies the incorporation
of insurance principles into the system of social protection for
the working population to protect those employed from falling
into poverty (Dang et al., 2021). The compulsory state social
insurance should aim to strengthen the social protection against
poverty for those who experience reduction or absence of income
due to a job loss, maternity, illness, injury, old age, or death of
the breadwinner (Wen and Wallace, 2019). In that regard, many
insurance programs were created, including a pension insur-
ance program, which guarantees life-long retirement payments
(Cuadros-Meñaca, 2020), and a health insurance program, which
helps to improve the quality of medical care and grant a specified
amount of free medical care to the population (Aizawa, 2019).
Any crisis affects the operation of insurance companies and
must be considered to protect the country’s population (Moreno
et al., 2020). In 2020, all countries around the world, including
Russia, faced the COVID-19 pandemic, which influenced the life
of many. The pandemic gave rise to new threats toward the
operation of insurance companies and more opportunities for
them to develop. This situation became a test for the Russian
insurance market. On the one hand, people have become more
interested in personal insurance, special COVID-19 insurance, and
life insurance schemes (Fashagba, 2021). On the other hand, some
corporate clients had problems due to quarantine restrictions
and had to cut their expenses (Ecer and Pamucar, 2021; Chen
and Zhao, 2022). The crisis forced everyone to quickly adapt to
constraints and to change business models and plans. Health
insurance is not the only area that changed because of quarantine
measures. It influenced all spheres of business in general. Any-
how, experts agree that the current crisis has become an effective
accelerator of digital transformation in the insurance industry
(Babuna et al., 2020; Contró et al., 2021).
Despite the considerable attention of researchers to insurance-
related issues, there is a clear lack of studies establishing a logical
relationship between household poverty and the implementation
of insurance services, both in the context of poverty reduction
and from the perspective of insurance market development. This
study seeks to narrow this gap.
Based on the results of literature review (Pia, 2022; Renahy
et al., 2018), the following hypotheses were put forward: (H1)
households with insufficient income tend to recuse themselves
from purchasing risk insurance; (H2) a demand for risk insurance
services is directly related to the amount of household savings.
The main purpose of this study is to identify the relationships
and interdependencies between the key financial characteristics
of low-income households and their propensity for insurance
purchase under the scenario where the insurance product can
reduce the likelihood of catastrophic expenses. To achieve the
above goal, the following objectives were formulated: (1) to con-
duct the literature review; (2) to decide on information sources
and to select methods for data collection and processing; (3) to
test the hypotheses; (4) based on the results, to formulate rec-
ommendations on how to increase the low-income households’
propensity to purchase insurance services. The focus is on the
insurance market of the Russian Federation.
L. Tsvetkova, I. Okhrimenko, T. Belousova et al. Journal of Behavioral and Experimental Finance 36 (2022) 100748

Fig. 3. Correlation matrix of 5 variables: Insurance premium per capita (IPPC;

Fig. 2. The main stages of the research project. Average income per capita (AIPC); Gross domestic savings (GDS), GDP per capita
Source: Developed by the authors. (GDPPC) and GINI Index.
Source: Developed by the authors.

2. Methods

2.1. Study design

A complex multi-stage research project with secondary in-

formation from official sources was conducted. The project was
implemented as a fully desk research. The main stages of the
research project are presented in Fig. 2.
Based on the results of the literature review, it was decided to
look into time series (Poontirakul et al., 2022; Renahy et al., 2018;
Pia, 2022). Econometric, economic-statistical and general scien-
tific methods were chosen to process the time series data. The
correlation-regression analysis aimed to investigate the strength
and direction of the relationships between various indicators, and
the analysis of variance was used to analyze the differences. The
Fig. 4. Results of regression analysis between insurance premium per capita and
results were presented in tables and graphs. Most calculations average income per capita.
were done using the standard tools of Microsoft Excel. The graph- Source: Developed by the authors.
ical representations of the data were completed using Microsoft
Office.
these patterns is that constructing a multi-regression model with
2.2. Data base a given set of factors makes no sense. Yet, given existence of these
relationships above, a decision was made to further build paired
The study is based on statistical information provided by the regression models for each factor.
Federal State Statistics Service of the Russian Federation. The
The first hypothesis to test was that about the relationship be-
time series model covers the period from 2000 to 2019 (Ros-
tween one’s propensity to purchase insurance and the household
stat, 2019), with the time step of 1 year. The key indicators
income level. The parallel analysis of data on insurance premiums
were: (1) total insurance premium; (2) per capita income; (3)
and per capita income revealed low interdependence (Fig. 4).
household savings. To determine whether there were logical re-
Further analysis revealed a relatively close relationship be-
lationships between the said variables, the following indicators
tween IPPC and GDP per capita (R2 = 0.84; Fig. 5). Note that the
were calculated 1) insurance premium per capita (IPPC, depen-
household savings rose sharply in 2015, after the threat of an
dent variable); (2) average income per capita (AIPC, independent
variable); (3) Gross Domestic Savings (GDS, independent vari- economic downturn. This trend was driven by the emergence of
able); (4) GDP per capita (GDPPC, independent variable); (5) GINI an income risk.
index (independent variable). The inputs are presented in Table 1. The fitness of the current regression model proves to be suffi-
cient, given the results from the analysis of variance (Table 2).
3. Results and discussion Because of the increasing propensity to save money in the
face of financial uncertainty, one could expect to see a correla-
To display the relationship between the examined variables, tion between the amount of savings and an insurance demand
a correlation matrix was built (Fig. 3). The period is for 2000 (Fig. 6).
to 2019 (20 years). The strongest associations were observed A relationship between IPPC and GDS appears to be the
between IPPC and the following predictors: GDS, GDP per capita, strongest relationship identified via regression analysis (R2 =
and AIPC; the weakest association was with the GINI index. On 0.96). The first hypothesis is thus confirmed. According to the
the one hand, one could argue that inequality and poverty do analysis of variance (Table 3), the regression model above is a
not affect the IPPC value, but what is interesting is that the GINI good fit for the examined data.
index correlates with AIPC, the value of which may affect the IPPC The results above show that individuals may purchase in-
value. Meanwhile, GDP per capita correlates with GDS, which, in surance serves in a bid to stay above the poverty line in the
turn, correlates with IPPC. The conclusion that can be drawn from income-decreasing event.
3
L. Tsvetkova, I. Okhrimenko, T. Belousova et al. Journal of Behavioral and Experimental Finance 36 (2022) 100748

Table 1
Background data from 2000–2019 for the regression analysis.
Source: Developed by the authors based on data from Rosstat (2021), World Bank 2021a,b,c.
Period Insurance Average income Gross domestic GDP per capita, Index GINI
premium per per capita, dollars savings, billion of international
capita, dollars of of USA US dollars dollars
USA
2000 56 486 101 10523.6 37.1
2001 46 478 105 11372.5 37.5
2002 49 460 107 12136.5 38.2
2003 58 501 135 13328.3 39.1
2004 74 589 193 14723.6 40.1
2005 88 612 254 16213.8 41.3
2006 106 659 335 18113.9 41
2007 128 730 441 20204.3 40.7
2008 157 797 553 21679.8 40.2
2009 113 667 300 21400.3 39.8
2010 127 769 454 21269.2 39.5
2011 157 811 654 22785.5 39.7
2012 182 792 675 24768.8 40.7
2013 197 806 646 26044.8 40.9
2014 175 713 581 25730.6 39.9
2015 116 496 403 24062.5 37.7
2016 121 460 361 24104.1 36.8
2017 150 547 455 25999.3 37.2
2018 162 530 550 27317.2 37.5
2019 156 546 532 28184.1 38.2

Table 2
Analysis of variance for the regression analysis between IPPC and GDP per capita.
Source: Developed by the authors.
df SS MS F F Sign
Regression 1 34834.6912 34834.6912 97.2216 0.0000
Residue 18 6449.4356 358.3020
Total 19 41284.1268
Factor Coefficients Standard Error t-Stat P-Value Lower 95% Higher 95%
Y-intersection −34.3970 16.3010 −2.1101 0.0491 −68.6441 −0.1499
GDPPC 0.0076 0.0008 9.8601 0.0000 0.0060 0.0092

Table 3
Analysis of variance for the regression analysis between IPPC and GDS.
Source: Developed by the authors.
df SS MS F F Sign
Regression 1 39492.0609 39492.0609 396.6691 0.0000
Residue 18 1792.0659 99.5592
Total 19 41284.1268
Factor Coefficients Standard Error t-Stat P-Value Lower 95% Higher 95%
Y-intersection 28.8392 5.1290 5.6228 0.0000 18.0636 39.6148
GDS 0.2348 0.0118 19.9166 0.0000 0.2100 0.2596

Fig. 6. Results of regression analysis between insurance premium per capita and
Fig. 5. Results of regression analysis between insurance premium per capita and
gross domestic savings.
GDP per capita.
Source: Developed by the authors.
Source: Developed by the authors.

4
L. Tsvetkova, I. Okhrimenko, T. Belousova et al.
The study failed to confirm the H1 hypothesis, and this finding
refutes the assumptions made by Zubets (2001). At the same
time, the given results are consistent with those published by
Ahmed et al. (2016), Chantarat et al. (2017), Garedew et al. (2020).
According to these authors, the high willingness of the poor to
pay for insurance services (80% to 90%) is not determined by their
income level. The findings of Binnendijk et al. (2013) on the direct
relationship between willingness to pay for insurance and income
level were also not confirmed in the study.
Confirmation of the H2 hypothesis suggests that households
tend to save more to maintain living standards when at risk of
economic recession. This conclusion indirectly confirms the pre-
vious evidence (Abdyusheva and Stepanov, 2019; Lugilde et al.,
2018; Wawrosz et al., 2019; Zuraina, 2018).
Comparing the present results with previous findings (Ab-
dyusheva and Stepanov, 2019; Ahmed et al., 2016; Bohn, 2018;
Garedew et al., 2020), it was found that relatively poor house-
holds can be encouraged to purchase insurance if the offered
product can help them avoid unexpected expenses and thus
save income. When designing an insurance product for a low-
income household, the following behaviors have to be considered.
First, households that almost broke free from poverty have little
concern about how the cost of insurance will affect their con-
sumer behavior, but feel positive about its potential to provide
deductible compensation for unsustainable losses by reducing the
insurance premium (Zhai et al., 2021). Second, those households
whose permanent income is slightly above the absolute poverty
line can afford a temporary decrease in consumption levels here
and now by deciding on the individual utility function (Bohn,
2018).
Insurance utility can be increased by subsidizing a part of
insurance premiums, for state subsidies cost less than the budget-
based compensation for potential losses. An alternative is to offer
liability insurance to households that take small business loans
without collateral.
The current findings can be utilized by insurance companies to
create insurance products for various segments of the population.
The study can also be useful to designing insurance programs for
the low-income population.
4. Conclusions
The comprehensive multi-stage desk research project with
time series modeling and correlation-regression analysis revealed
no relationship between one’s propensity to purchase insurance
and their level of income per capita. This finding indicates that
one’s willingness to pay for insurance is not determined by the
income level and refutes the previously formulated hypothesis
H1. A relationship was found between the amount of savings
and the average level of per capita income. This finding suggests
that households tend to save in order not to fall into poverty.
The amount of savings was found to be related to an insurance
demand of households, which confirms the hypothesis H2.
The present findings indicate that when driven by the fear of
absolute poverty, relatively poor households may feel a need for
insurance. One can see this trend during the period when risks
are high. In other words, households caught in insurance poverty
are the most promising insurers, provided that the service avoids
absolute poverty, or allows significant savings.
This study may be of interest both to insurance market prac-
titioners, who design new insurance products, and to represen-
tatives of state and municipal administration. In addition, the
study may be useful to academic researchers, as it opens up
new avenues for future research. Other researchers can investi-
gate, among other things, the factors that influence the demand
and willingness to pay for insurance protection among different
segments of the population.
5
Journal of Behavioral and Experimental Finance 36 (2022) 100748
CRediT authorship contribution statement
Liudmila Tsvetkova: Conceptualization, Data curation, Formal
analysis. Igor Okhrimenko: Investigation, Methodology, Project
administration, Resources. Tamara Belousova: Software, Super-
vision, Writing – original draft. Leonid Khuzhamov: Validation,
Visualization, Writing – review & editing.
Declaration of competing interest
The authors declare that they have no known competing finan-
cial interests or personal relationships that could have appeared
to influence the work reported in this paper.
Funding
This research did not receive any specific grant from funding
agencies in the public, commercial, or not-for-profit sectors.
Data availability
Data will be available on request.
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