Health insurance is essential in promoting and protecting the human right to health (Article 25 of the UDHR, preamble of the WHO Constitution, etc.). Although paying indemnities under health insurance policies can be seen as an expression of respect for this right, failures in executing these policies may constitute violations. In sub-Saharan Africa, access to health insurance and social protection remains limited, especially for vulnerable populations, who often face substantial challenges in enforcing their health insurance rights. In Mali, despite establishing a national health insurance scheme and adopting a universal health insurance law, the effective realization of the right to health remains a significant challenge. This chapter argues that the failure of insurance corporations to fulfill their contractual obligations can violate insured persons’ fundamental rights to health. Using the case of Mali within the Conférence Interafricaine des Marchés d’Assurances (CIMA) legal framework, it explores how private insurance actors can both support and undermine health rights. Ultimately, it contends that insurance companies operating in the CIMA region must be held accountable when their practices hinder realizing the right to health.