The Saudi Arabian insurance sector has two distinctive features. First, major revenue for this sector comes from the mandatory medical and motor insurance. Second, this sector is dominated by a few companies which generally provide the same products in the sector. Therefore, a company may focus on providing better service quality in order to attain future growth and stability. High-quality service is essential to gain a competitive advantage in the insurance sector. In this context, the present study identifies a gap in assessing the quality of service in the insurance sector of Saudi Arabia, using the SERVPERF scale in particular. Structural Equation Modeling is used to assess the quality of service. The results indicate that SERVPERF is not adequate to measure service quality in the context of Saudi Arabia. In the process, this study opens a debate on, whether a universally acknowledged SERVPERF scale is suitable to apply in an environment where service is of mandatory nature.

This paper aimed to examine a conceptual model for the relationships between hospital service quality, patient satisfaction, hospital utilization, and hospital financial performance. A total of 176 hospitals was selected from California State for this study. The standardized performance measures were used together with precisely defined specifications and standardized data collection protocols. First, an exploratory factor analysis with Varimax rotation was performed. The measurement prop-erties were then assessed in a confirmatory factor analysis (CFA). The analysis results show that quality had a significant effect on satisfaction, which, in turn, affected the financial performance. The results provide support for the previous findings indicated that service quality was positively associated with patient satisfaction and that satisfaction and utilization had a significant positive effect on financial performance. The analysis results provide support for the previous findings that hospital service quality is positively related to patient satisfaction. The findings also show that patient satisfaction and hospital utilization have a significant positive effect on hospital financial performance.