{
  "id": "clause-claims-cooperation",
  "type": "clause",
  "languages": {
    "en": {
      "id": "clause-claims-cooperation",
      "lang": "en",
      "type": "clause",
      "title": "Claims Cooperation Clause",
      "shortDefinition": "The claims cooperation clause obliges the cedent to notify the reinsurer of losses and involve it in claims handling, in some versions up to a consent requirement for settlements.",
      "synonyms": [
        "Claims control clause (stricter form)"
      ],
      "linesOfBusiness": [
        "Reinsurance"
      ],
      "jurisdictions": [
        "Global"
      ],
      "tags": [
        "Claims management",
        "Reinsurance"
      ],
      "relations": {
        "relatedTerms": [
          "term-cedent",
          "term-facultative-reinsurance",
          "clause-follow-the-fortunes"
        ],
        "partOf": [],
        "appliesTo": [
          "term-facultative-reinsurance",
          "term-treaty-reinsurance"
        ],
        "regulatedBy": [],
        "relevantFor": [],
        "insurableVia": [],
        "mitigatedBy": [],
        "comprises": [],
        "alternativeTo": [],
        "complementedBy": []
      },
      "attribute": null,
      "profile": null,
      "coverageProfile": null,
      "clause": {
        "kind": "condition",
        "origin": "reinsurance-market",
        "favours": "insurer",
        "negotiability": "negotiable",
        "standardWordings": []
      },
      "legalBasis": [],
      "standards": [],
      "reviewStatus": "expert-reviewed",
      "reviewedBy": "Guido Hesse, Hesse Group Holding AG",
      "lastReviewed": "2026-09-04",
      "version": "0.2.0",
      "updated": "2026-09-03",
      "generated": {
        "by": "cursor-agent/claude-sonnet-5",
        "at": "2026-09-03T00:00:00.000Z"
      },
      "verified": [
        {
          "by": "human:ghesse",
          "at": "2026-09-04T00:00:00.000Z",
          "method": null
        }
      ],
      "staleAfter": null,
      "url": "https://hgh.ch/lexikon/en/knowledge/clause/claims-cooperation-clause/",
      "alternateUrl": "https://hgh.ch/lexikon/de/wissen/klausel/claims-cooperation-klausel/",
      "body": "## Purpose\n\nThe claims cooperation clause obliges the cedent to notify the reinsurer of losses and involve it in claims handling. The milder cooperation form requires notification and consultation; the stricter claims control clause transfers the conduct of claims handling to the reinsurer. Cooperation clauses are common above all in facultative covers and where cession rates are high.\n\n## Effect and limits\n\nThe clause is in tension with the follow-the-fortunes principle: the more the reinsurer co-decides, the less it should later have to rely on the cedent's settlement decisions. If the cedent breaches the clause, benefits may be reduced or refused – in some jurisdictions even without proof of prejudice to the reinsurer.\n\n## Negotiation and practice\n\nNotification periods, thresholds and consent requirements should be embedded operationally in the cedent's claims processes so that, in a major loss, cover is not jeopardised by formal errors. The key negotiation point is whether the clause is drafted as a duty to consult (cooperation) or as a consent requirement (control)."
    },
    "de": {
      "id": "clause-claims-cooperation",
      "lang": "de",
      "type": "clause",
      "title": "Claims-Cooperation-Klausel",
      "shortDefinition": "Die Claims-Cooperation-Klausel verpflichtet den Zedenten, den Rückversicherer über Schäden zu informieren und ihn in die Schadenbearbeitung einzubinden, teils bis hin zum Zustimmungsvorbehalt bei Vergleichen.",
      "synonyms": [
        "Claims Control Clause (verschärfte Form)"
      ],
      "linesOfBusiness": [
        "Rückversicherung"
      ],
      "jurisdictions": [
        "Global"
      ],
      "tags": [
        "Schadenmanagement",
        "Rückversicherung"
      ],
      "relations": {
        "relatedTerms": [
          "term-cedent",
          "term-facultative-reinsurance",
          "clause-follow-the-fortunes"
        ],
        "partOf": [],
        "appliesTo": [
          "term-facultative-reinsurance",
          "term-treaty-reinsurance"
        ],
        "regulatedBy": [],
        "relevantFor": [],
        "insurableVia": [],
        "mitigatedBy": [],
        "comprises": [],
        "alternativeTo": [],
        "complementedBy": []
      },
      "attribute": null,
      "profile": null,
      "coverageProfile": null,
      "clause": {
        "kind": "condition",
        "origin": "reinsurance-market",
        "favours": "insurer",
        "negotiability": "negotiable",
        "standardWordings": []
      },
      "legalBasis": [],
      "standards": [],
      "reviewStatus": "expert-reviewed",
      "reviewedBy": "Guido Hesse, Hesse Group Holding AG",
      "lastReviewed": "2026-09-04",
      "version": "0.2.0",
      "updated": "2026-09-03",
      "generated": {
        "by": "cursor-agent/claude-sonnet-5",
        "at": "2026-09-03T00:00:00.000Z"
      },
      "verified": [
        {
          "by": "human:ghesse",
          "at": "2026-09-04T00:00:00.000Z",
          "method": null
        }
      ],
      "staleAfter": null,
      "url": "https://hgh.ch/lexikon/de/wissen/klausel/claims-cooperation-klausel/",
      "alternateUrl": "https://hgh.ch/lexikon/en/knowledge/clause/claims-cooperation-clause/",
      "body": "## Zweck\n\nDie Claims-Cooperation-Klausel verpflichtet den Zedenten, den Rückversicherer über Schäden zu informieren und ihn in die Schadenbearbeitung einzubinden. Die mildere Cooperation-Form verlangt Information und Konsultation; die strengere Claims-Control-Klausel überträgt dem Rückversicherer die Führung der Schadenbearbeitung. Üblich sind Kooperationsklauseln vor allem in fakultativen Deckungen und bei hohen Zessionsquoten.\n\n## Wirkung und Grenzen\n\nDie Klausel steht in Spannung zum Follow-the-Fortunes-Prinzip: Je stärker der Rückversicherer mitentscheidet, desto weniger kann er sich später auf die Regulierungsentscheide des Zedenten verlassen müssen. Verletzt der Zedent die Klausel, drohen Leistungskürzung oder -verweigerung – je nach Rechtsordnung bereits ohne Nachweis eines Schadens des Rückversicherers.\n\n## Verhandlung und Praxis\n\nMeldefristen, Schwellenwerte und Zustimmungserfordernisse sollten operativ in den Schadenprozessen des Zedenten hinterlegt sein, damit im Grossschadenfall keine Deckung durch Formfehler gefährdet wird. In der Verhandlung ist entscheidend, ob die Klausel als Konsultationspflicht (Cooperation) oder als Zustimmungsvorbehalt (Control) ausgestaltet wird."
    }
  }
}