Termination of a health insurance contract due to courtesy certificates

Convenient sick leave from healthy patients causes enormous damage to employers and health insurance companies every year. In addition to possible labor law, criminal law and disciplinary consequences, the issuance of courtesy certificates can also result in the termination of the health insurance contract concluded with the doctor. In decision R5-BSK/12, the Federal Arbitration Commission stated that incorrect certificates of incapacity for work constitute a serious breach of contract and professional duty, which entitles the health insurance company to terminate the individual contract the first time the breach occurs. The use of test patients (“mystery checks”) is also permitted to uncover these misconducts.