[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [Confidentiality and truth-telling](https://durgical.com/en/medical-ethics/areas/communication/) › Honesty with third parties: insurers, certificates and billing

# 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.

Updated Nov 13, 2026

## Key points

- WMA, paragraph 8: the physician certifies only what they have personally verified.
- Law 23 of 1981, art. 50: the medical certificate attests birth, state of health, treatment or death, and carries legal and moral responsibility.
- Law 23, art. 51: the text is clear, precise, strictly truthful and states the purpose for which it is issued.
- Law 23, art. 52: issuing a false certificate is a serious ethical offence, without prejudice to legal action.
- Exaggerating a diagnosis to obtain an authorisation is deception, even if the patient's good is sought.
- Faced with an unfair refusal, the path is to document the indication and use the formal channels, not to falsify data.

## 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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## Elsewhere in DurgiPedia

- [The death certificate in RUAF-ND](https://durgical.com/en/forensic-medicine/the-death-certificate-in-ruaf-nd/)

## Connections

## Related 5

- [Truthfulness: telling the patient the truth](https://durgical.com/en/medical-ethics/truthfulness-telling-the-patient-the-truth/)
- [Medical certificates: sick leave, death and medico-legal reports](https://durgical.com/en/medical-ethics/medical-certificates-sick-leave-death-and-medico-legal-reports/)
- [Conflicts of interest and relations with industry](https://durgical.com/en/medical-ethics/conflicts-of-interest-and-relations-with-industry/)
- [The WMA International Code of Medical Ethics](https://durgical.com/en/medical-ethics/the-wma-international-code-of-medical-ethics/)
- [Fidelity and dual loyalty](https://durgical.com/en/medical-ethics/fidelity-and-dual-loyalty/)

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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](https://www.wma.net/policies-post/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](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=68760) (Función Pública, Gestor Normativo, 1981); [Ley Estatutaria 1751 de 2015, que regula el derecho fundamental a la salud](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=60733) (Función Pública, Gestor Normativo, 2015).

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Source: https://durgical.com/en/medical-ethics/honesty-with-third-parties-insurers-certificates-and-billing/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/medical-ethics/honesty-with-third-parties-insurers-certificates-and-billing/