Reporting entity
1. Indicate which type of corporation this report covers.
- A single corporation
- Part of a corporation
- A consolidated family of corporations
- Other (specify)
2. Is the reporting entity part of a Canadian consolidation?
- Yes
- No
3. Does this reporting entity have investments in partnerships or joint ventures?
- Yes
- No
4. Indicate the accounting standard used to complete this questionnaire.
- International Financial Reporting Standards (IFRS)
- Accounting Standards for Private Enterprises (ASPE)
- United States Generally Accepted Accounting Principles (U.S. GAAP)
- Other (specify)
5. Indicate the currency used to complete this survey.
- Canadian dollars
- U.S. dollars
6. What are the start and end dates of this enterprise's reporting period for the quarter ending:
- From: YYYY-MM-DD to YYYY-MM-DD
Assets
7. Report your assets
- Cash and deposits – Canadian currency
- Cash and deposits – foreign currency
- Accounts receivable
- Allowance for credit losses on receivables
- Investments in and claims on parent, subsidiaries and affiliates ─ shares and equity
- In Canada
- Outside Canada
- Investments in and claims on parent, subsidiaries and affiliates ─ accumulated earnings
- In Canada
- Outside Canada
- Investments in and claims on parent, subsidiaries and affiliates ─ net assets of foreign offices
- Investments in and claims on parent, subsidiaries and affiliates ─ debt claims on affiliates
- In Canada
- Outside Canada
- Canadian investments in non-affiliates ─ debt securities issued by the Government of Canada
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Canadian investments in non-affiliates ─ debt securities issued by provincial and municipal governments
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Canadian investments in non-affiliates ─ debt securities issued by corporations, trusts or others
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Canadian investments in non-affiliates ─ corporate shares, fund or trust units and other equity
- Publicly traded
- Other equity
- Canadian investments in non-affiliates ─ other investments
- Foreign investments in non-affiliates ─ debt securities
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Foreign investments in non-affiliates ─ other investments
- Derivative assets
- Reverse repurchase agreements
- Mortgage loans to non-affiliates ─ secured by property in Canada
- Residential
- Non-residential
- Mortgage loans to non-affiliates ─ secured by property outside Canada
- Mortgage loans to non-affiliates ─ accumulated allowance for credit losses
- Non-mortgage loans to non-affiliates
- Non-mortgage to non-affiliates ─ accumulated allowance for credit loss
- Fixed assets
- Depreciable assets and land
- Investment properties
- Accumulated depreciation
- Deferred policy acquisition expense
- Intangible assets
- Goodwill
- Other intangible assets
- Accumulated amortization
- Recoverable from reinsurers
- Unearned premiums
- Unpaid claims and adjustments expenses
- Accrued pension asset
- ab. Deferred income tax asset
- ac. All other assets
- Specify all major items within other assets
- ad. Other allowances for credit losses
Total assets
Liabilities and equity
Liabilities
8. Report your liabilities.
- Unpaid claims and adjustment expenses
- Unearned premiums (at 100%)
- Deposits received on reinsurance ceded
- Accounts payable
- Income taxes payable
- Amounts owing to affiliates
- In Canada
- Outside Canada
- Borrowing from non-affiliates ─ mortgage loans
- Residential
- Non-residential
- Borrowing from non-affiliates ─ non-mortgage loans and overdrafts
- From lenders in Canada ─ banks
- From lenders in Canada ─ credit unions
- From lenders in Canada ─ other lenders in Canada
- From lenders outside Canada
- Borrowing from non-affiliates ─ debt securities
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Borrowing from non-affiliates ─ other borrowings
- Equity securities classified as liabilities
- Derivative liabilities
- Obligations related to repurchase agreements
- Unearned commissions
- Accrued pension liability
- Non-pension post retirement benefits
- Deferred income tax liability
- All other liabilities
- Specify all major items within other liabilities
Total liabilities
Equity
9. Report your equity.
- Share capital
- Preferred
- Common
- Contributed surplus
- Accumulated other comprehensive income
- Non-controlling interest
- Retained earnings
- Reserves required by the Office of the Superintendent of Financial Institutions, general reserves and contingency reserves
- Earned surplus
- Head office account
Total equity
Total liabilities and total equity
Earned surplus
10. Report your earned surplus.
- Earned surplus and head office accounts
- Opening balance
- Net income (loss) for the current period
- Transfers from (to) share capital
- a.4 All other additions (deductions)
- Specify all major items within other additions (deductions)
- Dividends declared
- Cash ─ preferred shares
- Cash ─ common shares
- Other dividends
Closing balance
Income Statement
11. What period does this income statement cover?
- From: YYYY-MM-DD to YYYY-MM-DD
12. Report your underwriting operations.
- Net premiums
- Direct premiums written
- Reinsurance assumed
- Reinsurance ceded
- Increase (decrease) in unearned premiums
- Net premiums earned
- Other underwriting revenue
- Underwriting revenue
- Claims incurred
- Direct claims
- Reinsurance assumed
- Reinsurance ceded
- Adjustment expenses
- Commissions
- Taxes ─ insurance operations
- Depreciation ─ underwriting
- Amortization
- Intangible assets
- Amortization ─ other
- Wages and salaries
- Employer portion of employee benefits
- Pension expense
- Current service cost
- Other pension expenses
- Stock options expense
- Indirect taxes
- Software, research and development
- Impairments
- Credit losses on receivables
- Other impairments
- Charitable donations
- Total claims and expenses
- Underwriting income before the undernoted
- Dividends and experience rating refunds to policyholders
- Underwriting gain (loss)
Investments and ancillary operations
13. Report your investments and ancillary operations.
- Interest revenue from Canadian sources
- Debt securities
- Debt claims on affiliates
- Mortgages
- Other interest revenue
- Interest revenue from foreign sources
- Dividends
- From Canadian corporations
- From foreign corporations
- Rental revenue
- All other investment revenues
- Specify all major items within other investment revenues
- Total investment revenue
- Interest expense
- Debt securities
- Amounts owing to affiliates
- Mortgages
- Other interest expenses
- Dividends paid on equity securities classified as liabilities
- Operating expenses applicable to investment operations
- Depreciation
- h.2 Other operating expenses
- Total investment expense
- Investment income before gains (losses) and ancillary income
- Gains and losses ─ fair value adjustments
- Realized
- Unrealized
- Income (loss) from ancillary operations
- Specify all major items within income (loss) from ancillary operations
- Net investment and ancillary income
- Gains and losses ─ foreign exchange
- Realized
- Unrealized
- All other revenues
- Specify all major items within other revenues
- All other expenses
- Specify all major items within other expenses
Income
14. Report your income.
- Income (loss) before income taxes
- Current income tax expense
- Deferred income tax expense
- Income (loss) after income taxes
- Equity in unconsolidated affiliates
- Net income (loss)
- Attributable to non-controlling interest
- Attributable to equity shareholders
- Other comprehensive income
- Items that will not be reclassified to net earnings
- Items that may be reclassified subsequently to net earnings
- Reclassification of realized (gains) losses to net earnings
- Income taxes
- Comprehensive income
- Attributable to non-controlling interest
- Attributable to equity shareholders
- Net income from foreign operations
Disclosure of selected accounts
15. Report premiums and claims by line of business (net of reinsurance)
- Canadian net premiums written
- Personal property
- Commercial property
- Automobile
- Accident and sickness
- Marine and aircraft
- Liability
- a.7 Other
- Total Canadian ─ net premiums written
- Canadian net premiums earned
- Personal property
- Commercial property
- Automobile
- Accident and sickness
- Marine and aircraft
- Liability
- b.7 Other
- Total Canadian ─ net premiums earned
- Canadian net claims incurred
- Personal property
- Commercial property
- Automobile
- Accident and sickness
- Marine and aircraft
- Liability
- c.7 Other
- Total Canadian ─ net claims incurred
- Foreign net premiums written
- Written by offices in Canada
- d.2 Written by offices outside Canada
- Total foreign ─ net premiums written
- Foreign net premiums earned
- Written by offices in Canada
- e.2 Written by offices outside Canada
- Total foreign ─ net premiums earned
- Foreign net claims incurred
- Written by offices in Canada
- f.2 Written by offices outside Canada
- Total foreign ─ net claims incurred
16. Report the number of policies in force by line of Canadian business.
- Property
- Personal
- Commercial
- Automobile
- Accident and sickness
- Marine and aircraft
- Liability
- Other line of Canadian business
Total number of policies in force from Canadian business
17. Report the number of policies in force from foreign business.
- Foreign business written by offices in Canada
- Foreign business written by offices outside Canada
Total number of policies in force from foreign business
Disclosure of selected accounts
18. Report other disclosures.
- Equity method dividends
- Canadian dividends
- Foreign dividends
- Securitized assets ─ recognized
- Credit cards
- Mortgages
- Other assets
- Securitized assets ─ unrecognized
- Credit cards
- Mortgages
- Other assets
- Capitalized expenses for software, research and
- Non-life technical reserves
19. Allocate the changes to selected assets and liabilities.
- Investments in and claims on parent, subsidiaries and affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- a.4 Other adjustments
- Closing balance
- Realized gains and losses
- Canadian and foreign investments in non-affiliates ─ debt securities
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- b.4 Other adjustments
- Closing balance
- Realized gains and losses
- Canadian and foreign investments in non-affiliates ─ corporate shares, funds or trust units and other equity
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- c.4 Other adjustments
- Closing balance
- Realized gains and losses
- Canadian and foreign investments in non-affiliates ─ other investments in non-affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- d.4 Other adjustments
- Closing balance
- Realized gains and losses
- Mortgage loans to non-affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- e.4 Other adjustments
- Closing balance
- Realized gains and losses
- Non-mortgage loans to non-affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- f.4 Other adjustments
- Closing balance
- Realized gains and losses
- Fixed assets ─ depreciable assets and land
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- g.4 Other adjustments
- Closing balance
- Realized gains and losses
- Fixed assets ─ investment properties
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- h.4 Other adjustments
- Closing balance
- Realized gains and losses
- Intangible assets
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- i.4 Other adjustments
- Closing balance
- Realized gains and losses
- Other assets
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- j.4 Other adjustments
- Closing balance
- Realized gains and losses
- Debt liability securities owing
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- k.4 Other adjustments
- Closing balance
- Realized gains and losses
- Other liabilities
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- l.4 Other adjustments
- Closing balance
- Realized gains and losses
- Derivatives (assets and liabilities)
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange valuation adjustments
- m.4 Other adjustments
- Closing balance
- Realized gains and losses