PurposeThis study aims to examine the influence of service quality (SQ) on customer loyalty (CL) and the mediating role of customer satisfaction (CS) and customer perceived value (CPV) in health insurance products in Malaysia.Design/methodology/approachData were conveniently collected through a self-administered questionnaire from subscribers to health insurance products and services in Malaysia. A total of 456 available questionnaires were used in the analysis. Partial least square (PLS) structural equation modelling (V3.3) was used to obtain the study results.FindingsA positive relationship is observed amongst the studied variables. In addition, CPV partially mediates the proposed relationship and also indirectly mediates the relationship between SQ and CS. Lastly, CS partially mediates the proposed relationship. Hence, all proposed direct and indirect relationships are significant and positive.Research limitations/implicationsThis research increases the authors’ understanding of the role of CS, SQ and CPV on CL in the health insurance industry in a developing country. The study also shows that insurance companies must establish positive relationships between insurers and customers by providing excellent SQ to maintain CS and loyalty.Practical implicationsThis research will help managers and guide the policymakers to establish a national health financing scheme. Furthermore, these results will guide industry players on how to maintain existing and targeting customers.Social implicationsThis study has attempted to provide a comprehensive understanding of CL in the Malaysian health insurance industry. Considering the limited research in the Malaysian health insurance context, this study can provide theoretical contribution and a managerial basis for future studies, including implications for the managers. However, to date, research in this sector under the Malaysian context is not adequate to consider SQ, perceived values and CL factors.Originality/valueThis study has attempted to provide a comprehensive understanding of CL in the Malaysian health insurance industry. Considering the limited research in the Malaysian health insurance context, this study can provide theoretical contribution and a managerial basis for future studies, including implications for the managers.