Honesty with third parties: insurers, certificates and billing
- Topic
Doctors do not lie on the patient's behalf: a certificate, a report to an insurer or a bill must state only what is true.
What it is
Truthfulness does not end with what the doctor tells the patient. It also binds the doctor towards third parties who rely on their word: the employer who receives a sick note, the insurer or health organisation that pays according to the diagnosis, the judge who reads a report, and the health system that funds what is billed. The temptation is usually «kind»: exaggerating a diagnosis to get a test authorised, signing a sick note the patient asks for without examining them, or changing a code so that a service is paid. Even when done to help, it is a lie that damages trust in all medical certificates and diverts resources from other patients. The «Truthfulness» page covers the truth with the patient; this one, the truth with others.
Key facts
- Sick notes: the days the examination justifies are certified; if the patient asks for more, it is explained that the certificate states only what was verified.
- Backdated certificates or certificates without examination: certifying a state of health that was not checked goes against art. 51 of Law 23 and paragraph 8 of the WMA Code.
- Diagnostic codes: the real diagnosis is recorded; choosing a more serious one so that the service is paid falsifies the medical record.
- Billing for procedures not done, or more complex than those done, is fraud on the health system, not a matter of style.
- Reports to life or health insurers: answer what is known, without hiding or inventing; if the patient does not authorise the report, it is not sent.
- Law 23, arts. 40 and 41: the doctor does not take commercial benefits from those who supply what they prescribe, nor charge or pay for referring patients.
In clinical practice
- «Doctor, put down that it's urgent so they authorise it faster»: the real priority is recorded and, if there is an unfair delay, the patient is told about the complaint mechanisms.
- A student asks for a certificate to excuse missing an exam they skipped for another reason: it is refused respectfully, explaining that the certificate states only what was verified.
- A doctor who made a mistake on a certificate does not correct it by hand: they issue a new one and note the error in the record.
- If an organisation presses for a cheaper diagnosis to be recorded, the doctor documents the real one and reports it through the institution's channels.
Legal framework in Colombia
- Law 23 of 1981, arts. 50, 51 and 52: definition, truthful content and the ethical sanction for a false certificate.
- Law 23 of 1981, arts. 40 and 41: ban on commercial benefits and on fees for referring patients.
- Statutory Law 1751 of 2015, art. 17, paragraph: forbids offering or promoting perks or gifts to health professionals and workers.
- Official texts checked on 2026-11-13 at funcionpublica.gov.co.
Test yourself
Think of the answer, then tap the question to see it.
What does the International Code of Medical Ethics say about certificates?
That the physician certifies only what they have personally verified (paragraph 8).
Which article of Law 23 of 1981 requires a certificate to keep to the truth?
Art. 51: the text must be clear, precise, strictly truthful and state the purposes for which it is issued.
What is the ethical consequence in Colombia of issuing a false medical certificate?
It is a serious ethical offence (Law 23 of 1981, art. 52), without prejudice to any legal action that applies.
Is it acceptable to exaggerate a diagnosis so that the insurer authorises a needed test?
No. It is deception, even if done for the patient's good; the real indication is documented and the formal complaint mechanisms are used.
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Connections
Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.
Sources: WMA International Code of Medical Ethics (World Medical Association, 2022); Ley 23 de 1981, por la cual se dictan normas en materia de ética médica (Función Pública, Gestor Normativo, 1981); Ley Estatutaria 1751 de 2015, que regula el derecho fundamental a la salud (Función Pública, Gestor Normativo, 2015).
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