In any complex social system, pressure on common resources increases when individual responsibility is weak. Public systems are vulnerable to abuse, passivity, and inefficient allocation. Insurance intervenes not only to provide financial protection but also to introduce a form of contractual discipline.

The insurer has the necessary strength to confront a doctor in the event of malpractice. Where the individual patient lacks the expertise, financial means, or legal tools to challenge a medical error, the insurer can act on their behalf. Through this mechanism, additional forms of control and professional accountability are introduced, without resorting to additional public bureaucracy.

Accountability through contract Link to heading

If public systems are often based on passive rights, insurance implies reciprocal obligations. The contractual relationship between the insured and the insurer creates a framework in which responsible behaviors are not only encouraged but become explicit conditions for maintaining protection and reducing entropy.

The insured should know that:

  • Risks must be declared honestly. Any omission or falsification may lead to loss of coverage.

  • Preventive measures must be taken. For example, installing anti-theft systems, following medical treatments, or not driving recklessly.

  • Regular contributions are required. Premium payments are a form of continuous commitment that maintains the balance of the common fund.

This accountability through contract transforms insurance into an active, not just reactive, instrument. The beneficiary is not just a passive consumer but a participant in a pact of discipline and prevention.

Beyond protection: Behavioral adaptation Link to heading

Insurance is not just a compensation mechanism but also a system of behavioral feedback. When risky behaviors are penalized (through higher premiums) and prudent ones rewarded (through discounts or access to services), the insured learns to adapt.

Unlike state interventions, which can be uniform and rigid, insurance can personalize the response based on individual history. A careful driver will benefit from a bonus, while one with many accidents will bear a malus. This dynamic mechanism corrects behaviors gradually and proportionally.

For example:

  • Smokers pay more for life insurance.
  • Drivers with multiple fines will have higher motor liability premiums.
  • Companies investing in workplace safety benefit from lower liability insurance premiums.

Thus, insurance not only cushions risks but reduces them through behavioral modeling. Instead of paying for mistakes, individuals and organizations are encouraged to avoid them. This is a form of evolutionary responsibility, adapted to each actor’s reality.

Insurance, not subscription: correcting the medical system Link to heading

Choosing medical insurance instead of a mere subscription to a single hospital makes the difference between limited protection and systemic responsibility. Unlike a provider that has an interest in defending its staff even in cases of negligence, the insurer has a different stake: the correctness of medical acts and overall risk control.

In a subscription-based system:

  • the patient is loyal to a single center, even if it offers variable quality services;
  • malpractice complaints are often handled internally, with no real consequences;
  • incompetent doctors are rotated or protected, not objectively evaluated;
  • as the number of subscribers grows, a volume pressure appears, leading to decreased quality of medical services and overburdened staff.

In an insurance-based system:

  • the patient has access to extensive provider networks, with real freedom to choose or change the provider;
  • damages are analyzed by independent third parties, outside the interests of the medical institution;
  • if a medical error is found, the insurer has a direct interest in reporting it to the hospital;
  • the hospital, under pressure from reputation and rising premiums, is encouraged to take corrective actions and is financially and legally supported in the process of dismissing a doctor who repeats mistakes or ignores protocols.

Thus, insurance brings healthy pressure and an emphasis on natural selection and responsibility. It not only provides compensation but introduces a self-correcting mechanism in the medical ecosystem. It can reconfigure behaviors, eliminate incompetence, and restore patient trust. This is the real added value: not just compensation but a constant pressure for improvement.

The actuary’s role in market balancing Link to heading

An essential aspect in the efficient functioning of insurance—be it health, professional liability, or contractual guarantee—is the impartial calculation of price. This is not arbitrary but the result of a rigorous risk assessment — a task in which the actuary plays a central role.

A fair price has corrective effects not only in the relationship between insured and insurer but reverberates throughout the entire ecosystem:

  • entrepreneurs with a good track record benefit from lower rates, strengthening fair competitiveness;
  • those with weak practices bear higher costs, being forced either to improve or exit the market;
  • beneficiaries (contracting authorities or private clients) end up selecting bidders not just based on gross price but also on insured risk — a more sustainable approach.

In this sense, the actuary not only evaluates risk but shapes the economic behavior of the entire market. Insurance thus becomes a qualitative filter, not just a payment mechanism.

Through a biomimicry lens, where a keystone species (like the otter or elephant) can stabilize an entire ecosystem, the actuary — through pricing — becomes a balancing factor between individual and collective interest.

However, this role is only possible as long as the actuary is allowed to exercise professional autonomy, outside arbitrary interventions that distort market mechanisms. Whenever artificial schemes are imposed — such as price caps, administratively imposed bonus-malus systems or targeted subsidies — the price no longer reflects the real risk, and the corrective function of insurance is seriously affected. Instead of encouraging responsible behavior, the market ends up rewarding conformism or opportunism.

For insurance to remain a qualitative filter and the actuary a balancing agent, it is essential that technical pricing mechanisms remain independent, data-based, not based on conjunctural decisions or ad-hoc pressures.