實務上，商業長照保險市場規模始終無法擴大，以至於形成各種論述來解釋此一奇特的商業長照保險需求現象 (Long-Term Care Insurance Puzzle)。我們根據行為財務學的心靈帳戶理論 (mental accounting) 作為研究方法，觀察一般理性個人，當同時具備主觀死亡風險與主觀長命風險時，對於商業長照保險需求，的確會形成互相抵銷的效果，最終導致商業長照保險需求始終無法擴大的困境。研究貢獻可供壽險公司參酌，根據現代人同時受到主觀死亡風險與主觀長命的差異化影響，發展兼具這兩種風險的新型態商業長照保險，藉以擴大商業長照保險的利基。

(184_M6aa10fc369237_Abs.pdf(檔案不存在))

In practice, the commercial long-term care insurance (LTCI) market has consistently failed to expand, leading to various discussions attempting to explain this unique phenomenon, known as the Long-Term Care Insurance Puzzle. Drawing on the theory of mental accounting from behavioral finance, this study examines how rational individuals simultaneously influenced by perceived mortality risk and perceived longevity risk may experience offsetting effects in their decision-making, ultimately leading to stagnant demand for LTCI. Our findings offer valuable insights for life insurance companies, suggesting that by acknowledging the dual and often conflicting impacts of perceived mortality and longevity risks, insurers can develop innovative LTCI products that integrate both risk dimensions. Such products may better align with consumers’ psychological frameworks and help unlock growth potential in the LTCI market.

(184_M6aa10fc369237_Abs.pdf(檔案不存在))

Ameriks, J., Briggs, J., Caplin, A., Shapiro, M. D., & Tonetti, C. (2016). The long-term-care insurance puzzle: Modeling and measurement (NBER Working Paper No. 22726). National Bureau of Economic Research. https://doi.org/10.3386/w22726 Blake, D., & Li, J. (2024). Longevity risk and capital markets: The 2022–2023 update. The Geneva Papers on Risk and Insurance—Issues and Practice, 49(2), 229–233. https://doi.org/10.1057/s41288-024-00314-3 Brown, J. & Finkelstein, A., (2004a). Supply or demand: Why is the market for LTC insurance so small? (NBER Working Paper No. 10782). National Bureau of Economic Research. https://doi.org/10.3386/w10782 Brown, J. R., & Finkelstein, A. (2004b). The interaction of public and private insurance: Medicaid and the long-term care insurance market (NBER Working Paper No. 10989). National Bureau of Economic Research. https://doi.org/10.3386/w10989 Brown, J. R., & Finkelstein, A. (2007). Why is the market for long-term care insurance so small? Journal of Public Economics, 91(10), 1967–1991. https://doi.org/10.1016/j.jpubeco.2007.02.010 Brown, J. R., & Finkelstein, A. (2008). The interaction of public and private insurance: Medicaid and the long-term care insurance market. American Economic Review, 98(3), 1083–1102. https://www.jstor.org/stable/29730107 Brown, J. R., Coe, N. B., & Finkelstein, A. (2006). Medicaid crowd-out of private long-term care insurance demand: Evidence from the Health and Retirement Study (NBER Working Paper No. 12536). National Bureau of Economic Research. https://doi.org/10.3386/w12536 Brown, J. R., & Finkelstein, A. (2011). Insuring long-term care in the United States. Journal of Economic Perspectives, 25(4), 119–142. https://doi.org/10.1257/jep.25.4.119 Cheng, Y., & Han, X. (2013). Does large volatility help? Stochastic population forecasting technology in explaining real estate price processes. Journal of Population Economics, 26(1), 323–356. https://doi.org/10.1007/s00148-010-0349-1 Cocco, J. F., & Gomes, F. J. (2012). Longevity risk, retirement savings, and financial innovation. Journal of Financial Economics, 103(3), 507–529. https://doi.org/10.1016/j.jfineco.2011.10.002 Davidoff, T. (2010). Home equity commitment and long-term care insurance demand. Journal of Public Economics, 94(1–2), 44–49. https://doi.org/10.1016/j.jpubeco.2009.09.006 De Nardi, M., French, E., & Jones, J. B. (2009). Life expectancy and old age savings. American Economic Review, 99(2), 110–115. https://doi.org/10.1257/aer.99.2.110 Fels, M. (2020). Mental accounting, access motives, and overinsurance. The Scandinavian Journal of Economics, 122(2), 675–701. https://doi.org/10.1111/sjoe.12336 Gatzert, N., & Wesker, H. (2014). Mortality risk and its effect on shortfall and risk management in life insurance. Journal of Risk and Insurance, 81(1), 57–90. https://doi.org/10.1111/j.1539-6975.2012.01496.x Gujarati, D. N. (1995). Basic econometrics (3rd ed.). McGraw-Hill. Klimaviciute, J., & Pestieau, P. (2020). Insurance with a deductible: A way out of the long-term care insurance puzzle. Journal of Economics, 130, 297–307. https://doi.org/10.1007/s00712-020-00700-0 MacMinn, R., Brockett, P., & Blake, D. (2006). Longevity risk and capital markets. Journal of Risk and Insurance, 73(4), 551–557. https://doi.org/10.1111/j.1539-6975.2006.00188.x Menoncin, F. (2008). The role of longevity bonds in optimal portfolios. Insurance: Mathematics and Economics, 42(1), 343–358. https://doi.org/10.1016/j.insmatheco.2007.05.001 Milevsky, M. A., Moore, K. S., & Young, V. R. (2006). Asset allocation and annuity-purchase strategies to minimize the probability of financial ruin. Mathematical Finance, 16(4), 647–671. https://doi.org/10.1111/j.1467-9965.2006.00288.x Mommaerts, C. (2016). Long-term care insurance and the family [Working paper]. https://www.aeaweb.org/conference/2017/preliminary/paper/Ak22d8D9 OECD. (2006). Projecting OECD health and long-term care expenditures: What are the main drivers? (OECD Economics Department Working Papers No. 477). OECD Publishing. https://doi.org/10.1787/736341548748 Olivieri, A., & Ferri, S. (2003). Mortality and disability risks in long-term care insurance. International Actuarial Association. https://www.actuaries.org/IAAHS/OnlineJournal/2003-1/Mortality_and_Disability _Risks_in_Long_Term_Care_Insurance.pdf Pestieau, P., & Ponthière, G. (2010). Long-term care insurance puzzle (PSE Working Paper No. halshs-00564862). Paris School of Economics. https://shs.hal.science/halshs-00564862 Pitacco, E. (2016). Premiums for long-term care insurance packages: Sensitivity with respect to biometric assumptions. Risks, 4(1), Article 3. https://doi.org/10.3390/risks4010003 Pitthan, F., & De Witte, K. (2021). Puzzles of insurance demand and its biases: A survey on the role of behavioural biases and financial literacy on insurance demand. Journal of Behavioral and Experimental Finance, 30, Article 100471. https://doi.org/10.1016/j.jbef.2021.100471 Post, T. (2012). Individual welfare gains from deferred life annuities under stochastic mortality. Asia-Pacific Journal of Risk and Insurance, 6(2). https://doi.org/10.1515/2153-3792.1154 Sakvarelidze, A. (2025). The impact of behavioral economics on consumer decision-making in the insurance industry. Health Policy, Economics and Sociology, 8(2). https://doi.org/10.52340/healthecosoc.2024.08.02.09 Schulze, R. N., & Post, T. (2010). Individual annuity demand under aggregate mortality risk. Journal of Risk and Insurance, 77(2), 423–449. https://doi.org/10.1111/j.1539-6975.2009.01340.x Stevens, R. (2010). Annuity decisions with systematic longevity risk [Working paper]. Tilburg University. https://web.actuaries.ie/sites/default/files/erm-resources/Annuity_Decisions_with _Systematic_Longevity_Risk.pdf Tien, J. J., & Miao, J. C. Y. (2013). How households adjust their consumption and investment plans under longevity risk: An experimental approach-based study in Taiwan. The Geneva Papers on Risk and Insurance—Issues and Practice, 38(4), 803–823. https://doi.org/10.1057/gpp.2013.22 Uluçay, A. P., Yazıcı, S., & Döndürücü, Z. B. (2024). Overconfidence and optimism biases in insurance purchasing decisions and overcoming them through nudge. In E. Siniksaran (Ed.), Overcoming cognitive biases in strategic management and decision making (pp. 139–163). IGI Global. https://doi.org/10.4018/979-8-3693-1766-2.ch009 Yeh, S.-C. J., Wang, W.-C., Chou, H.-C., & Chen, S.-H. S. (2021). Private long-term care insurance decision: The role of income, risk propensity, personality, and life experience. Healthcare, 9(1), Article 102. https://doi.org/10.3390/healthcare9010102 Yogo, M. (2016). Portfolio choice in retirement: Health risk and the demand for annuities, housing, and risky assets. Journal of Monetary Economics, 80, 17–34. https://doi.org/10.1016/j.jmoneco.2016.04.008