Abstract

CARPIO-FREIRE, Karen Elizabeth; MERINO-SANCHEZ, Wilson Yovanny  and  DELGADO-RODRIGUEZ, Ramiro Nanac. Right to health and clauses in prepaid medical insurance policies in the canton of Quito. Noesis [online]. 2025, vol.7, n.esp1, pp.950-961.  Epub Nov 30, 2025. ISSN 2739-0365.  https://doi.org/10.35381/noesisin.v7i1.457.

The research was based on the premise that health is a fundamental right that requires effective guarantees from the State, in a context in which the population of Quito resorted to prepaid medical policies between 2018 and 2020. The objective was to analyze the legal and social implications of the clauses included in these contracts in relation to the right to health. A qualitative approach was applied, based on document review, analysis of constitutional regulations, and observation of official statistical information. The results showed that the contractual clauses limited access to coverage, generating dissatisfaction among users and contradictions with the inalienable nature of public health. It was concluded that, although private policies offered an alternative to the deficiencies of the state system, the ambiguous contractual conditions violated constitutional rights and revealed the need for a clearer and more protective regulatory framework.

Keywords : Right to health; health insurance; social security; health legislation..

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