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Client Value Matrix


MILK completed a landscape review of existing research related to client value, and aggregated findings in the following matrix, which summarizes findings by type of value and type of product.

  Context Category KEY CODE
TYPE OF STUDY: RCT: Randomized control trial. Quant: Other quantitative analysis
TYPE OF STUDY: Qual: Qualitative study. Lit: Literature review
CONCLUSIONS IN STUDY: (+) yes (-) no (~) mixed or inconclusive (o) not yet available
 
Microinsurance Other Insurance Other Risk Management14
Questions Agriculture Health Other Agriculture Health & Life
Expected Value (When Claims are not made) Does insurance lead to reduced savings?   RCT: Karlan et al (+)
Quant: Chou et al 2003 (+)
Quant: SMERU (o)   Quant: Farley and Wilensky 1985 (+)Quant: Engen and Gruber 2001 (+) (LIFE INSURANCE) Quant: Hubbard et al 1995 (+),Powers 1995 (+)
             
Do households with insurance borrow less when an insured event happens? RCT: Carter et al (o), Cole et al (o) Quant: Chou et al 2003 (+), Hamid et al 2010a (+), Wagstaff and Pradhan 2005 (+) Aggarwal 2010 (~) Karlan et al (o),     Quant: Gruber and Yelowitz 1999 (+) Starr-McCluer 1996 (-) Quant: Eswaran and Kotwal 1989 (+), Hodinott 2006 (+)
             
Does insurance increase business investment or lead to riskier business decisions? RCT: Cai et al 2010 (+) Gine and Yang 2009 (-) Karlan et al 2010 (~) Carter et al (o), Cole et al (o), Mude et al (o), Osei et al (o)
Quant: Hill and Viceisza 2010 (+) Patankar et al (o), Shukla et al (o)
RCT: Karlan et al (o)   Quant: Horowitz and Lichtenberg 1993 (+), O’Donoghue et al 2007 (+) Goodwin et al 2004 (~), Roberts et al 2003 (~), Roberts et al 2007 (-)   RCT: Dupas and Robinson 2010 (+), Duflo et al 2009 (+)
Quant: Dercon 1996 (+), Eswaran and Kotwal 1989 (+), Fafchamps 1992 (+), Fafchamps and Pender 1997 (+) Bouchet et al 2008 (-), Dercon and Christiaensen 2008 (-) Kurosaki and Fafchamps 2002 (~)
Qual: Giné et al 2010 (-)
             
Does insurance provide “peace of mind” effects on the health and psychology of clients   RCT: Karlan et al (+) Chemin et al (o)
Qual: Young 2006 (+)
Quant: Sync Consult 2006 (+)
Qual: Hintz 2010 (+), Young 2006 (+)
  Quant: Lave and Ricci 1998 (+) RCT: Ashraf et al 2010 (+)
             
Does having insurance empower clients to take decisions? RCT: Karlan et al 2010 (+) Qual: Young 2006 (+) Qual: Young 2006 (~)      
               
Financial Value (When claims are made) Does insurance protect assets? Quant: Chanterat et al 2009 (+) Quant: Aggarwal 2010 (+), Kruk et al 2009 (+) Pham and Pham (o)       Quant: Fafchamps and Lund 2003 (+), Hodinott 2006 (+)
             
Do households with insurance borrow less when an insured event happens?   RCT: Karlan et al (-)
Quant: Aggarwal 2010 (+), Kruk et al 2009 (+) Pham and Pham (o)
       
             
Does insurance lead to lower recurring expenses?15   RCT: Thornton et al 2009 (-) Lepine et al (o), Rutten et al (o)
Quant: Aggarwal 2010 (+), Franco et al 2008 (+), Msuya et al 2004 (+), Schneider and Diop 2001 (+), Wagstaff and Pradhan 2005 (+) Bogg et al 1996 (-), Diop et al 2006 (-), Gumber 2001 (-), Rao et al 2009 (-), Wagstaff 2007 (-), Wagstaff et al 2009 (-) Chankova et al 2008 (~), Ekman 2007 (~), Lei and Lin 2009 (~), Schneider and Hanson 2006 (~) Pham and Pham (o)
Qual: McGuinness and Mandel (o)
Lit: Ekman 2004 (+), Jakab and Krishnan 2001 (+) ILO 2002 (~)
Quant: SMERU (o)
Qual: Hintz 2010 (-)
  Quant: Long and Masi 2009 (~)  
Financial Value (When claims are made) Does insurance lead to lower expenses or greater income protection for catastrophic events? RCT: Giné et al 2007 (+) Cole et al (o), Mude et al (o)
Quant: Giné et al 2007 (+) Katie School (~) Patankar et al (o), Shukla et al (o)
RCT: Duflo et al (o), Rutten et al (o)
Quant: Aggarwal 2010 (+),Chankova et al 2008 (+), Devadasan et al 2007 (+), Diop et al 2006 (+), Franco et al 2008 (+), Jütting 2004 (+), Limwattananon et al 2007 (+), Msuya et al 2004 (+), Ranson 2001 (+), Ranson 2002 (+), Schneider and Diop 2001 (+), Sun et al 2009, (+), Wagstaff 2007 (+), Wagstaff and Pradhan 2005 (+), Yip and Berman 2001 (+), Ekman 2007 (-), Gumber 2001 (-), Rao et al 2009 (-), Sparrow et al 2010 (-), Wagstaff et al 2009 (-), Wagstaff and Lindelow 2008 (-), Xu et al 2006 (-) Dror et al 2009 (~), Lei and Lin 2009 (~), Schneider and Hanson 2006 (~) Pham and Pham (o)
Qual: McGuinness and Mandel (o)
Lit: Ekman 2004 (+), Jakab and Krishnan 2001 (+) ILO 2002 (~), Wagstaff 2008 (~)
Quant: Morsink (o)   Quant: Long and Masi 2009 (~) Quant: Chowdhury (+) Gertler and Gruber 2002 (-)
             
Does insurance lead to cash flow smoothing? Quant: Hess 2003 (+) Breustedt et al 2008 (~) Patankar et al (o), Shukla et al (o) RCT: Karlan et al (-) CIRMb (o), Duflo et al (o), Rutten et al (o)
Quant: Aggarwal 2010 (+), Franco et al 2008 (+), Hamid et al 2010a (+) Pham and Pham (o)Qual: Young 2006 (+)
Quant: Morsink (o)     Quant: Eswaran and Kotwal 1990 (+), Dercon 1996 (+), Dercon and Krishnan 2003 (+), Yang and Choi 2007 (+) Gertler and Gruber 2002 (-) Deaton 1992 (~), Dercon and Krishnan 2000 (~), Fafchamps and Lund 2003 (~), Hodinott 2006 (~), Kazianga and Udry 2006 (~)Qual: Dercon 2000 (~), Morduch 1995 (~)
             
Do insurance and other risk management tools have complementary (rather than competing) functions? RCT: Giné and Yang 2009 (-)Quant: Hess 2003 (+) Tobacman and Stein (o) RCT: Fitzpatrick et al (+) Karlan et al (o)
Quant: Jowett 2003 (-)
Quant: Sync Consult 2006 (-)Qual: Hintz 2010 (-)   Quant: Long et al 2009 (+)Quant: Engen and Gruber 2001 (-) LIFE INSURANCE Quant: Attanasio and Rios-Rull 2000 (-), Dercon and Krishnan 2003 (-) Ligon 2002 (~)Qual: Clarke and Dercon 2009 (~), Collins et al 2009 (~), Dercon 2000 (~), Morduch 1995 (~), Saldaña-Zorilla 2007 (~)
               
Service Quality Value (Externalities produced by providing services) Does insurance increase utilization of healthcare services?   RCT: Fitzpatrick et al (+), Karlan et al (+) Thornton et al 2009 (-) CIRMb (o), LeMay-Boucher et al (o), Rutten et al (o)
Quant: Atim 1999 (+), Criel and Kegels 1997 (+), Criel et al 1999 (+), Cheng and Chiang 1997 (+), Diop et al 2006 (+), Dror et al 2005, (+), Dror et al 2006 (+), Dror et al 2009 (+), Franco et al 2008 (+), Hamid et al 2010b (+), Devadasan et al 2007 (+), Jowett 2004 (+), Jütting 2004 (+), Kagubare 2005 (+), Lei and Lin 2009 (+), Msuya et al 2004 (+), Noterman et al 1995 (+), Polonsky et al 2009 (+), Rao et al 2009 (+), Schneider and Diop 2001 (+), Schneider and Hanson 2006 (+), Schneider and Racelis 2004 (+), Smith and Sulzbach 2008 (+), Sparrow et al 2010 (+), Trujillo et al 2005 (+), Wagstaff 2007 (+), Wagstaff and Pradhan 2005 (+), Wagstaff et al 2009 (+), Yip and Berman 2001 (+) Aggarwal 2010 (~), Chankova et al 2008 (~), Gnawali et al 2009 (~), Ranson 2001 (~), Waters 1999 (~), Xu et al 2006 (~) Pham and Pham (o)Qual: Chee et al 2002 (+), Young 2006 (+) McGuinness and Mandel (o)
Lit: ILO 2002 (+), Jakab Krishnan 2001 (+)
    RCT: Manning et al 1987 (+)Quant: Card et al 2004 (+), Lave and Ricci 1998 (+), Long and Masi 2009 (~) Lit: Kendall (+)
             
Does insurance improve the quality of healthcare services received by the insured?   Quant: Cheng and Chiang 1997 (-) Bauchet et al 2010 (~) CIRMb (o), LeMay-Boucher et al (o), Morduch (o)
Qual: Chee et al 2002 (+), McGuinness and Mandel (o)Lit: Ekman 2004 (-)
       
             
Does insurance improve health outcomes?   RCT: Fitzpatrick et al (~) CIRMb (o), Duflo et al (o), Karlan et al (o), LeMay-Boucher et al (o), Levine et al (o), Lepine et al (o)
Quant: Aggarwal 2010 (+), Dror et al 2005 (+), Hamid et al 2010b (+), Wang et al 2009 (+)Qual: McGuinness and Mandel (o)Lit: ILO 2002 (~)
    RCT: Manning et al 1987 (~)
Quant: McWilliams et al 2007 (+) Card et al 2004 (~), Lei and Lin 2009 (~)
Quant: Hodinott 2006 (~)
             
Does insurance lead to education or access to other products or services? Quant: Hess 2003 (+) Quant: Bauchet et al 2010 (+), Hamid et al 2010a (+) Quant: Sync Consult 2006 (+)      
               
Demand/Customer Satisfaction (Satisfies what clients want) What determines the take up of insurance? RCT: Cai et al 2010, Carter et al, Giné and Yang 2009, de Janvry et al, Mude et alQuant: Hill et al 2010, Chanterat et al 2009, Cole and Gaurav, Giné et al 2008, Patankar and Upadhyay, Shukla et al, Tobacman and Stein, Wahhaj and Outes-LeonQual: Giné et al 2010 RCT: Chemin and de Laat, de Janvry et al, Karlan et al, Khan et al, Thornton et al 2009
Quant: Ahsan et al, Bendig et al 2009, Bhat and Jain, Dercon et al, Donfouet and Makaudze 2010, Gumber 2001, Jowett 2003, Lammers et al , LeMay-Boucher et al, Morduch, Rao et al 2009, Schneider and Diop 2001
Qual: Chee et al 2002
Quant: Geisbert 2008, Morskink   RCT: Flores et al 2005 RCT: Ashraf et al 2006
Quant: Bendig et al 2009, Kouame
             
What determines whether clients are satisfied with or renew policies? Quant: Hill et al 2009, Hill and Robles 2010 RCT: CIRMa, Fitzpatrick et al, Thornton et al 2009 Quant: Geisbert 2008      
               

14 This column describes devices other than insurance (including savings, asset accumulation and sales, formal and informal credit, and gifts) in their capacity as risk-management mechanisms. For purposes of this column, these other mechanisms should be substituted for “insurance” in each question (e.g. “Does insurance lead to reduced savings?” becomes “Does access to credit lead to reduced savings?”). Also described in this column are studies showing the impact that an absence of risk management tools has on the questions (e.g. “Does lack of access to credit lead to increased savings?”)

15 Where a study analyzes products covering both catastrophic and routine, recurring expenses and does not distinguish between catastrophic and recurring expenses in its outcomes, we have categorized the impact on expenses as both recurring and catastrophic.

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