Natural disaster losses have been increasing worldwide. Insurance is thought to play a critical role in improving resilience to these events by both promoting recovery and providing incentives for investments in hazard mitigation. This review first examines the functioning of disaster insurance markets broadly and then turns to reviewing empirical studies on the role of natural disaster insurance in recovery and the impacts of disaster insurance on incentives for ex ante hazard mitigation and land use. Rigorous empirical work on these topics is limited. The work that has been done suggests that insurance coverage does improve recovery outcomes, but impacts on risk reduction may be modest. More studies comparing outcomes across insured and uninsured properties are needed, particularly for better understanding the role of insurance in climate adaptation.