Managed competition and user satisfaction ‐ The case of Spanish work accident mutuals

Analyzes one of the three options of insurance against workplace accidents that Spanish companies can choose from: work accident and occupational disease mutual insurance companies. Although the taking out of insurance cover is obligatory, the choice is totally voluntary. The fact that these entities manage 90 per cent of premiums destined towards workplace accident cover collected by the Department of Social Security, allows us to assume that user satisfaction must be, consequently, quite high. In order to explore this, a study was made of the incentives that the combination of competition, regulation and ownership generated in these entities, and a postal survey of 443 companies affiliated to mutuals was carried out. Our results confirm the high rate of user satisfaction, although they also reveal some of the limitations associated with managed competition.