New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 35 - VIATICAL SETTLEMENTS
Appendix - APPENDIX
Universal Citation: NJ Admin Code
Current through Register Vol. 56, No. 24, December 18, 2024
| Mortality Experience Table |
| By Number of | ||||
| Contracts | ||||
| ................. | ||||
| Life Expectancy | In Force | Contracts added | Expected | Actual |
| at Issue | 01/01/---- | during year | Deaths | Deaths |
| ................. | ||||
| < 6 months | ||||
| ................. | ||||
| 6 to 12 months | ||||
| ................. | ||||
| 12 to 18 months | ||||
| ................. | ||||
| 18 to 24 months | ||||
| ................. | ||||
| 24 months or more | ||||
| ................. | ||||
| By Amount of | ||||
| Insurance | ||||
| ................. | ||||
| Life Expectancy | In Force | Contracts added | Expected | Actual |
| at Issue | 01/01/---- | during year | Deaths | Deaths |
| ................. | ||||
| < 6 months | ||||
| ................. | ||||
| 6 to 12 months | ||||
| ................. | ||||
| 12 to 18 months | ||||
| ................. | ||||
| 18 to 24 months | ||||
| ................. | ||||
| 24 months or more | ||||
| ................. |
| In column 1, enter the number of contracts in force or amount of insurance in |
| force under viatical settlements as of the beginning of the year, broken down |
| by the life expectancy on which the original consideration was based. |
| In column 2, enter the number of contracts added during the year. |
| In column 3, enter expected deaths (number or amount) from columns 1 and 2, |
| as estimated by the provider's actuary and based on life expectancy |
| assumptions. |
| In column 4, enter the actual deaths (number or amount) from columns 1 and 2. |
| ........................................... | ................................. |
| Signature of Member of the American Academy | Date |
| of Actuaries | |
| ........................................... | |
| Print Name |
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