This research proposes the application of a hierarchical and multidimensional model for quality measurement in health insurance services. The modelling assumes that perceived health insurance quality is composed of a three-stage hierarchical structure, which includes primary quality dimensions, interaction, environment conditions and outcome and each primary dimension is supported from the following sub-dimensions: Interaction quality (attitude), behaviour and expertise; environment conditions quality (environment conditions), design and social factors; and outcome quality (waiting time, tangibles and valence). For model validation, structural equation system is used. The application through structural equation modelling showed that only the outcome quality is significant to the overall perceived quality with the health insurance, and significant sub-dimensions for the study were social conditions, waiting time and tangible. The application of the modelling provided the estimation of the determinants of quality in the service. The determinants of perceived quality can help managers in the direction of improvement actions in order to increase the quality perceived by the users of health insurance services.
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