Proposals to form an insurance mechanism to support Small Island Developing States’ adaptation to climate change were first raised in 1991. At that time, the Alliance of Small Island States proposed an international, state-based insurance framework to assist adaptation to sea level rise. After two decades, an effective agreement and institutional structure on climate change insurance is yet to be realised. However, in the last two years, insurance has resurfaced in negotiations within the United Nations Framework Convention on Climate Change process. The 2013 United Nations climate conference meeting in Warsaw created a loss and damage mechanism and reinvigorated interest in risk transfer mechanisms to assist developing countries in adapting to climate change. This article argues that an existing regional international disaster risk-pooling facility, the Caribbean Catastrophe Risk Insurance Facility, offers an instructive model for a regional risk transfer mechanism to further adaptation to climate change-related extreme weather events in the Pacific. The article concludes that there is a good case, on pragmatic grounds and also under existing burden sharing principles in global climate governance, for leading developed states to take a leadership role in developing regional risk-pooling initiatives in the Pacific.