PART 1

• 1.Statements prepared under this Form must be prepared, so far as practicable, in tabular form and must be identified by numbers and letters corresponding with those of the items of Part 2 of this Form.
• 2.Except with respect to rates of premium or contribution, items in statements prepared under this Form must be shown to the nearest dollar.
• 3.Extra premiums where shown separately in Form 10C must not be included in statements prepared under this Form.
• 4.Every statement prepared under this Form must be prepared and signed by the actuary appointed under section 61(1) of the Act.
• 5.For the purposes of this Form —
  • extra premiums means a charge for any risk not provided for in the minimum contract premium;
  • net premiums means the premiums for which credit is taken in the valuation in connection with which any statement is prepared; and
  • valuation date means, in relation to any valuation, the date as at which the valuation is made.
• 6.Statements must be prepared under this Form both for the total business before deduction in respect of reinsurances of the risks of the insurer, and for those reinsurances.
• 7.Where the rates of office premiums required to be shown in any statement prepared under this Form are the same as the rates shown in any statement previously so prepared and submitted to the Reserve Bank, it shall be sufficient to refer to the rates so shown in such manner as to enable the Reserve Bank to ascertain the required information.

PART 2

The Statements to be prepared under this Part are as follows—

• 1.Statements as to policies issued in Fiji, separately prepared in respect of policies with and without participation in profits, showing—
  • (a)in relation to policies for the whole term of life, the rates of office premiums charged, in accordance with the published tables in use, for new policies giving the rates for decennial ages of entry from 20 to 70 inclusive;
  • (b)in relation to endowment insurance policies, the rates of office premiums charged, in accordance with the published tables in use, for new policies with original terms of 10, 15, 20, 30 and 40 years, giving the rates for ages at entry 20, 30 and 40, but excluding policies under which the age at maturity exceeds 60;
  • (c)in relation to policies specified in the preceding provisions of this item under which a continuous disability benefit is granted, the office premiums for that benefit under new policies, and the conditions which must be fulfilled before a continuous disability benefit—
    • (i)is allowed
    • (ii)ceases to be allowed; and
  • (d)in relation to sinking fund policies the rates of office premiums charged in accordance with the published tables in use for new policies with original terms of 10, 15, 20 and 30 years, provided that, in the case of industrial policies, there must be shown, in lieu of the rates of office premiums charged as specified in the foregoing items, the sums insured by new policies, in accordance with the published tables in use, in return for fixed weekly and monthly office premiums and in addition the sums insured for ages at entry 1, 5, 10 and 15.
• 2.Statements must be separately prepared in respect of policies with immediate profits, with deferred profits, and without profits, showing in quinquennial groups—
  • (a)in relation to policies on single lives for the whole term of life—
    • (i)the total amount insured (specifying sums insured and reversionary bonuses separately), grouped according to ages attained;
    • (ii)the amount per annum, after deducting abatements made by application of bonus, of office premiums payable throughout life, and of the corresponding net premiums, grouped according to ages attained; and
    • (iii)the amount per annum, after deducting abatements made by application of bonus, of office premiums payable for a limited number of years, and of the corresponding net premiums, grouped in accordance with the grouping adopted for the purposes of the valuation;
  • (b)in relation to endowment insurance policies on single lives—
    • (i)the total amount insured (specifying sums insured and reversionary bonuses separately), grouped in accordance with the grouping adopted for the purposes of the valuation; and
    • (ii)the amount per annum, after deducting abatements made by application of bonus, of office premiums payable and of the corresponding net premiums, grouped in accordance with the grouping adopted for the purposes of the valuation;
  • (c)in relation to policies specified in the preceding provisions of this item, under which a continuous disability benefit is granted—
    • (i)the total amount of continuous disability benefit insured under the policies, grouped in accordance with the grouping adopted for the purposes of the valuation; and
    • (ii)the amount per annum, after deducting abatements made by application of bonus, of office premiums payable (including premiums of which payment is, at the valuation date, suspended owing to disability arising from sickness or accident) and the corresponding net premiums, grouped according to the grouping adopted for the purposes of the valuations; and
  • (d)in relation to sinking fund policies (other than annuity policies)—
    • (i)the total amount insured (specifying sums insured and reversionary bonuses separately) grouped according to the number of complete years from the valuation date to the date of maturity of the policies; and
    • (ii)the amount per annum, after deducting abatements made by application of bonus, of office premiums payable, and of the corresponding net premiums grouped according to the number of years’ payments remaining to be made, provided that—
      • (a)in relation to endowment insurance policies or sinking fund policies which will reach maturity in less than 5 years, and which are grouped for the purposes of the valuation according to the years in which the policies will mature for payment, the information required by subparagraphs (b)(i), (c)(i) and (d)(i) must be given for each year instead of quinquennial groups; and
      • (b)where the net premiums in respect of policies for the whole term of life with premiums payable for a limited number of years, or the net premiums in respect of endowment insurance policies, are grouped for the purposes of the valuation otherwise than according to the number of years’ payments remaining to be made, or where the sums insured under endowment insurance policies are grouped for the purposes of the valuation otherwise than according to the years in which the policies will mature for payment or in which they are assumed to mature if earlier than the true year, then, in any such case, the valuation constants and an explanation of the method by which they are calculated must be given for each group, and, in the case of the sums insured under endowment insurance policies, a statement must also be given of the amount insured maturing for payment in each of the 2 years following the valuation date.
• 3.Statements in relation to immediate annuities on single lives for the whole term of life and annuities which were originally deferred but which have been entered into before or on the valuation date, separately prepared in respect of annuities on male and female lives, showing in quinquennial age groups the total amount of those annuities, grouped according to ages attained at the valuation date.
• 4.Statements in relation to deferred annuities which have not been entered upon before or on the valuation date, separately prepared in respect of annuities on male and female lives, showing in quinquennial groups—
  • (a)the total number of those annuities, grouped according to the number of years from the valuation date to the date the annuity is to be entered upon, and either—
    • (i)the average age (obtained by weighting according to the amount of the annuity) attained at the valuation date by the prospective annuitants; or
    • (ii)the valuation constants and an explanation of the method by which they are calculated; and
  • (b)the amount per annum of office premiums payable and of the corresponding net premiums, grouped according to the number of years’ payments remaining to be made.
• 5.Statements in relation to sinking fund policies, being immediate annuity policies, showing in quinquennial groups the total amount of those annuities, grouped according to the number of years from the valuation date to the date the annuities cease to be payable.
• 6.Statements showing in quinquennial groups the amount per annum of continuous disability benefits payable at the valuation date in respect of disability of more than one year’s duration, grouped according to ages attained.
• 7.Statements showing the total amount of continuous disability benefit paid and premiums waived in each of the 5 years immediately preceding the valuation date.