I've asked the same question at the Quantitative Finance StackExchange.
Consider the following example:
"As a risk-averse consumer, you would want to choose a value of x so as to maximize expected utility, i.e.
Given actuarially fair insurance, where p = r, you would solve: max pu(w - px - L + x) + (1-p)u(w - px), since in case of an accident, you total wealth would be w, less the loss suffered due to the accident, less the premium paid, and adding the amount received from the insurance company.
Differentiating with respect to x, and setting the result equal to zero, we get the first-order necessary condition as: (1-p)pu'(w - px - L + x) - p(1-p)u'(w - px) = 0,
which gives us: u'(w - px - L + x) = u'(w - px)
Risk-aversion implies u" < 0, so that equality of the marginal utilities of wealth implies equality of the wealth levels, i.e.
w - px - L + x = w - px,
so we must have x = L.
So, given actuarially fair insurance, you would choose to fully insure your car. Since you're risk-averse, you'd aim to equalize your wealth across all circumstances - whether or not you have an accident.
However, if p and r are not equal, we will have x < L; you would under-insure. How much you'd underinsure would depend on the how much greater r was than p."
Now, how the condition u"<0 changes anything to reach the result expressed above?