Belgium

Clinical Trial Application	Belgium Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Between 400.000 and 600.000 €/patient Between 3.000.000 and 5.000.000 €/protocol
Tail Coverage	3 years
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in French • Local EU Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address). Not required if Sponsor is domiciled in the EU.

Clinical Trial Application	Colombia Clinical Trial Quote Request
Mandated Coverage	Yes
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Spanish • Local Legal Representative details (Contact Person Name, Telephone Number and E-mail Address) • Site List required in Spanish if a generic statement that all sites are covered by the policy is insufficient for the EC - Note that Colombian tax is 16%. There is currently no mechanism set up in Colombia for payment of taxes on non-admitted business - The carrier would evidence the tax on the policy, however they would not collect this so the Sponsor needs to be aware that this may become payable in the future