{
  "id": "clause-ex-gratia-payments",
  "type": "clause",
  "languages": {
    "en": {
      "id": "clause-ex-gratia-payments",
      "lang": "en",
      "type": "clause",
      "title": "Ex-Gratia Payments Clause",
      "shortDefinition": "The ex-gratia payments clause governs whether and to what extent voluntary goodwill payments made by the cedent without legal liability are also shared by the reinsurer.",
      "synonyms": [
        "Goodwill payments clause"
      ],
      "linesOfBusiness": [
        "Reinsurance"
      ],
      "jurisdictions": [
        "Global"
      ],
      "tags": [
        "Reinsurance",
        "Claims management"
      ],
      "relations": {
        "relatedTerms": [
          "clause-follow-the-fortunes",
          "term-cedent"
        ],
        "partOf": [],
        "appliesTo": [
          "term-treaty-reinsurance"
        ],
        "regulatedBy": [],
        "relevantFor": [],
        "insurableVia": [],
        "mitigatedBy": [],
        "comprises": [],
        "alternativeTo": [],
        "complementedBy": []
      },
      "attribute": null,
      "profile": null,
      "coverageProfile": null,
      "clause": {
        "kind": "claims",
        "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": "0.1.0",
      "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/ex-gratia-payments-clause/",
      "alternateUrl": "https://hgh.ch/lexikon/de/wissen/klausel/ex-gratia-payments-klausel/",
      "body": "## Purpose\n\nCedents sometimes make payments to policyholders for customer relations or reputational reasons even though there is no legal liability to pay (ex gratia). Since reinsurance in principle only shares the contractually owed indemnity, the clause clarifies whether and how such goodwill payments feed into the reinsurance account.\n\n## Effect and limits\n\nMarket practice is either to exclude ex-gratia payments from reinsurance cover entirely, or to require the reinsurer's prior consent before payment so that it can decide whether to participate. Without the clause, uncertainty exists as to whether follow the fortunes also covers voluntary payments – the prevailing view is that it does not, absent legal liability.\n\n## Negotiation and practice\n\nCedents with a strong interest in customer retention sometimes negotiate a limited allowance of goodwill payments not requiring prior consent, so they can act quickly in individual cases without seeking approval each time."
    },
    "de": {
      "id": "clause-ex-gratia-payments",
      "lang": "de",
      "type": "clause",
      "title": "Ex-Gratia-Payments-Klausel",
      "shortDefinition": "Die Ex-Gratia-Payments-Klausel regelt, ob und in welchem Umfang freiwillige Kulanzzahlungen des Zedenten ohne rechtliche Leistungspflicht auch vom Rückversicherer mitgetragen werden.",
      "synonyms": [
        "Kulanzzahlungsklausel"
      ],
      "linesOfBusiness": [
        "Rückversicherung"
      ],
      "jurisdictions": [
        "Global"
      ],
      "tags": [
        "Rückversicherung",
        "Schadenmanagement"
      ],
      "relations": {
        "relatedTerms": [
          "clause-follow-the-fortunes",
          "term-cedent"
        ],
        "partOf": [],
        "appliesTo": [
          "term-treaty-reinsurance"
        ],
        "regulatedBy": [],
        "relevantFor": [],
        "insurableVia": [],
        "mitigatedBy": [],
        "comprises": [],
        "alternativeTo": [],
        "complementedBy": []
      },
      "attribute": null,
      "profile": null,
      "coverageProfile": null,
      "clause": {
        "kind": "claims",
        "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": "0.1.0",
      "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/ex-gratia-payments-klausel/",
      "alternateUrl": "https://hgh.ch/lexikon/en/knowledge/clause/ex-gratia-payments-clause/",
      "body": "## Zweck\n\nZedenten leisten aus Kundenpflege oder Reputationsgründen manchmal Zahlungen an Versicherte, obwohl keine rechtliche Leistungspflicht besteht (Ex-gratia). Da die Rückversicherung grundsätzlich nur die vertraglich geschuldete Leistung mitträgt, klärt die Klausel, ob und wie solche Kulanzzahlungen in die Rückversicherungsabrechnung einfliessen.\n\n## Wirkung und Grenzen\n\nMarktüblich ist entweder ein vollständiger Ausschluss von Ex-gratia-Zahlungen aus der Rückversicherungsdeckung oder eine Zustimmungspflicht des Rückversicherers vor der Zahlung, damit dieser sich zur Mitübernahme entscheiden kann. Ohne die Klausel besteht Unsicherheit, ob Follow-the-Fortunes auch freiwillige Zahlungen erfasst – die herrschende Meinung verneint dies mangels rechtlicher Leistungspflicht.\n\n## Verhandlung und Praxis\n\nZedenten mit hohem Interesse an Kundenbindung verhandeln teils ein begrenztes Kontingent zustimmungsfreier Kulanzzahlungen mit dem Rückversicherer, um im Einzelfall schnell handeln zu können, ohne jedes Mal eine Freigabe einzuholen."
    }
  }
}