N.J. Admin. Code § Tit. 11, ch. 4, subch. 35, app APPENDIX
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 |
N.J. Admin. Code Tit. 11, ch. 4, subch. 35, app APPENDIX