The "service account" in Exchange is in the most basic sense, the Administrator account. It is often assigned a unique account for security and for flexibility even if the same person is the administrator. It it really the cornerstone of the server and is required for it to run at all.
It is given permissions for the Exchange Server directory during the setup process. The service account, by default, has permissions for all of the objects in the directory. Windows NT accounts in the directory are referred to by their Windows NT Security Identifier (SID) values, and not by their names. If the service account is deleted from the Windows NT Accounts database, none of the Exchange Server services can start. Even if you recreate this serviceaccount using the identical name and password, the SID value associated with this account is not the same as that of the previous account.
For many functions (particularly administrative) and to have full access to your exchange server, you'll need Service Admin priviledges.
Hope this helps...