Insurance can reduce the financial consequences of illness, accidents, cyberattacks, disability, and other uncertain events. Nevertheless, the availability of an insurance product does not guarantee that individuals or organizations will purchase it. Decisions may be constrained by affordability, limited information, distrust, administrative complexity, social expectations, or uncertainty about whether a policy will provide meaningful protection.
TPB insurance research examines these decisions using the Theory of Planned Behavior, originally formulated by social psychologist Icek Ajzen. The model proposes that behavior is principally preceded by behavioral intention. Intention, in turn, is influenced by three components: attitude toward the behavior, subjective norms, and perceived behavioral control.
In an insurance context, attitude represents whether a person considers purchasing coverage beneficial or undesirable. Subjective norms describe perceived expectations from family members, colleagues, advisers, or other influential groups. Perceived behavioral control concerns whether the person believes that purchasing insurance is financially, cognitively, and practically feasible.
Recent studies have applied this framework to health insurance, family takaful, microtakaful, and cyberinsurance. However, the evidence does not support a single universal hierarchy of determinants. The importance of each TPB component varies according to the population, insurance product, institutional environment, and research design.
The Scientific Foundations of TPB Insurance Research
From behavioral beliefs to insurance intentions
In the conventional TPB model, behavioral beliefs generate an attitude toward an action. A consumer may evaluate insurance positively when coverage is expected to reduce financial exposure, improve access to services, or protect dependents. Conversely, exclusions, difficult claims procedures, uncertain benefits, or high premiums may contribute to a negative evaluation.
Normative beliefs concern the perceived approval or disapproval of relevant people. Insurance decisions are rarely made in complete social isolation. Family members may influence health or life insurance choices, while professional peers and cybersecurity specialists may affect organizational cyberinsurance decisions.
Control beliefs concern factors that facilitate or obstruct the behavior. For TPB insurance research, these factors can include disposable income, insurance knowledge, digital access, product availability, eligibility requirements, and confidence in comparing policies. Perceived behavioral control may affect intention and, when it accurately reflects actual resources, may also influence behavior more directly.
Intention is not equivalent to purchase
A critical distinction in TPB insurance research is the difference between purchase intention and observed purchase behavior. A respondent can express a strong intention to acquire coverage but subsequently remain uninsured because premiums increase, suitable products are unavailable, enrollment is complicated, or personal circumstances change.
Consequently, studies measuring only self-reported intention cannot establish that the participants ultimately purchased or renewed insurance. The intention–behavior gap is especially important in markets where low-income households encounter substantial liquidity constraints.
The TPB is therefore primarily a predictive framework for intentional behavior, not a complete economic model of insurance demand. It does not automatically incorporate adverse selection, asymmetric information, contractual exclusions, insurer solvency, regulatory mandates, or dynamic premium adjustments. These mechanisms require complementary theories and empirical methods.
Recent Evidence from Health Insurance Studies
Health insurance intentions among Indian consumers
A 2024 study by Mishra and colleagues applied an extended TPB model to health insurance intentions among tobacco and alcohol consumers in India. The initial model included attitude, subjective norms, perceived behavioral control, perceived usefulness, perceived product risk, and purchase intention.
The investigators collected 420 responses, of which 389 were retained for analysis. The research used exploratory factor analysis and confirmatory modeling. Subjective norms, perceived behavioral control, and perceived product risk were positively and significantly associated with health insurance purchase intention. However, the attitude and perceived-usefulness items were removed during scale refinement because of insufficient or cross-factor loadings.
This result should be interpreted carefully. It does not demonstrate that attitude or usefulness is universally irrelevant to insurance adoption. Instead, it shows that the particular measurements used in this sample did not produce sufficiently distinct and reliable constructs. Moreover, the study used convenience sampling in the Delhi National Capital Region, and more than 85% of retained respondents were between 18 and 30 years old. Generalization to older people, rural populations, or India as a whole would therefore be inappropriate.
The study nevertheless provides evidence that social influence and consumers’ confidence in handling insurance-related information, time, and financial requirements can be important. It also indicates that perceived product risk—concern that coverage may not perform as expected—must be treated as an active component of the decision rather than as background uncertainty. Read the 2024 study in Frontiers in Public Health.
What the 2025 systematic review adds
A 2025 systematic review in BMC Health Services Research examined 48 empirical journal articles on health-insurance purchase intentions published from 2014 through 2023. The authors initially identified 874 records through Scopus, Web of Science, and ScienceDirect. They subsequently applied screening and eligibility criteria to construct the final evidence base.
Across the reviewed studies, the researchers identified 141 factors associated with health-insurance purchase intentions. The Theory of Planned Behavior was the most frequently used named theory, but it appeared in only three articles. Twenty-six of the 48 studies did not specify any theoretical framework, while the remainder collectively used numerous different theories.
This finding reveals both the relevance and the limitations of TPB insurance research. TPB was more common than any competing named framework in the review, yet the overall literature remained theoretically fragmented. Research was also geographically concentrated, particularly in China, the United States, and India. Evidence from smaller and lower-income countries was comparatively limited.
Questionnaires were the predominant data-collection instrument, and many studies used cross-sectional designs. These methods can identify associations but are generally unable to demonstrate how intentions develop over time or whether intentions result in actual enrollment. The reviewers consequently recommended greater geographical diversity, richer research designs, and more attention to underexamined behavioral determinants. Consult the 2025 systematic review.
Takaful and Microtakaful as TPB Insurance Contexts
Participation in Indonesian microtakaful
Takaful is a cooperative form of risk protection structured according to Islamic financial principles. Microtakaful adapts this approach to populations that may have limited income or restricted access to conventional insurance.
A 2023 Indonesian study applied an extended TPB model to microtakaful participation. The authors analyzed survey data from 428 respondents using structural equation modeling. Subjective norms, knowledge, and price were among the variables associated with participation intentions.
The findings were not entirely linear. Compatibility positively influenced attitude, and normative beliefs positively influenced subjective norms. However, attitude did not produce the straightforward positive relationship with participation intention that a basic TPB interpretation might predict. Price-related results also illustrated the complexity of treating affordability as a simple favorable or unfavorable variable.
The study concluded that knowledge and pricing remained important obstacles to microtakaful development. These results suggest that favorable social expectations cannot compensate fully for unclear products or unaffordable contributions. Read the Indonesian microtakaful study.
Family takaful and decomposed TPB models
Recent family takaful studies have increasingly used the decomposed Theory of Planned Behavior. Instead of treating attitude, norms, and perceived control as indivisible variables, decomposed models examine their underlying beliefs.
Attitude may be decomposed into perceived compatibility, relative advantage, or expected financial value. Subjective norms can be divided into family, peer, religious, or professional influences. Perceived behavioral control may incorporate affordability, knowledge, self-efficacy, and access to providers.
This structure can improve explanatory detail, but it also creates methodological risks. Researchers may add numerous variables without providing a strong theoretical reason for each extension. Closely related measurements can overlap, producing discriminant-validity problems. The resulting models may fit a specific sample while remaining difficult to reproduce elsewhere.
Therefore, the scientific value of an extended TPB insurance model depends on preregistered hypotheses, validated measurements, adequate sample sizes, and replication across populations—not merely on the number of included constructs.
TPB Insurance Research Beyond Personal Health Coverage
Cyberinsurance adoption
Cyberinsurance differs from health or family insurance because purchase decisions are often made within organizations. Adoption may involve managers, information-security specialists, financial officers, legal teams, insurers, and external brokers. The relevant subjective norm is consequently organizational rather than exclusively interpersonal.
A behavioral model of cyberinsurance adoption published in 2021 integrated TPB with protection-related variables. This line of research indicates that an organization’s evaluation of cyberinsurance, perceived expectations from stakeholders, and confidence in its capacity to obtain appropriate coverage can contribute to adoption intention.
Nevertheless, cyberinsurance purchasing is also influenced by factors that TPB alone cannot represent adequately. These include security maturity, incident history, policy exclusions, insurer questionnaires, premium volatility, regulatory obligations, and uncertainty over whether specific cyber losses will be covered. See the cyberinsurance behavioral-model study in Sustainability.
Insurance literacy, trust, and product transparency
Recent research increasingly extends TPB insurance models with insurance literacy, perceived risk, trust, service quality, and product knowledge. These additions are plausible because insurance contracts are complex and their value is frequently realized only after an adverse event.
Insurance literacy may improve perceived behavioral control by helping consumers compare premiums, benefits, exclusions, waiting periods, deductibles, and claims processes. Trust may influence attitude if consumers believe that an insurer will administer claims fairly. Product transparency may affect both perceived control and perceived risk.
However, studies do not always define these concepts consistently. Financial literacy, insurance literacy, product knowledge, and self-reported familiarity are related but non-identical constructs. Treating them as interchangeable can obscure the mechanisms responsible for adoption.
Scientific Limitations and Future Research Priorities
Cross-sectional and self-reported evidence
Much of the TPB insurance literature relies on one-time questionnaires and structural equation modeling. These methods are useful for evaluating hypothesized relationships between latent variables, but they do not establish temporal or causal order.
Common-method bias is another concern because the same respondent often reports attitudes, social norms, perceived control, and intention in a single survey. Social desirability can also inflate intentions: respondents may say that purchasing insurance is responsible even when they are unwilling or unable to pay.
Longitudinal research should measure beliefs before enrollment and then verify actual purchase, renewal, lapse, and claims behavior. Where ethically and practically possible, researchers could link survey responses with anonymized administrative data.
Need for experiments and cross-cultural replication
Experimental designs could test whether clearer exclusions, simplified enrollment, premium subsidies, comparison tools, or peer information change TPB variables and actual insurance behavior. Randomized interventions would provide stronger causal evidence than cross-sectional associations.
Cross-cultural replication is equally necessary. Family influence, institutional trust, religious compatibility, digital literacy, and access to formal finance differ substantially across countries. A model validated among young urban respondents cannot be assumed to describe rural households, older populations, informal workers, or corporate decision-makers.
Current science therefore does not support a universal TPB insurance formula. The framework offers a structured set of hypotheses, but the relative influence of attitudes, norms, and control must be tested for each insurance product and population.
Conclusion
TPB insurance research provides a valuable psychological framework for examining why consumers and organizations intend to purchase insurance. Its three central mechanisms—attitude, subjective norms, and perceived behavioral control—translate naturally into questions about expected protection, social influence, affordability, knowledge, and access.
Recent health-insurance research suggests that social norms, perceived control, product risk, literacy, and financial conditions can influence purchase intentions. Studies of takaful and microtakaful further demonstrate the importance of knowledge, compatibility, social expectations, and pricing. Cyberinsurance research shows that the framework can also be extended to organizational decisions.
Nevertheless, intention should not be confused with verified enrollment. Cross-sectional questionnaires, convenience samples, inconsistent measurements, and limited geographical coverage continue to restrict the evidence base. The next generation of TPB insurance studies should prioritize longitudinal observation, behavioral records, experimental interventions, transparent measurement, and cross-cultural replication.
Terminological note: “TPB insurance” is not a recognized insurance product. In scientific literature, the expression refers to the application of the Theory of Planned Behavior (TPB) to insurance adoption, purchase intentions, participation, or payment behavior. The article therefore uses “TPB insurance research” as the grammatically and scientifically appropriate keyword.
Subscribe to our newsletter!
