Costa Rica

Costa Rica

Costa Rica

Costa Rica

Clinical Trial Application

Costa Rica Clinical Trial Quote Request

Mandated Coverage

Unknown. Please confirm with your CRO.

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
• Legal Representative in Costa Rica or Local CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address)

No refund for policy cancellation

Ecuador

Ecuador

Clinical Trial Application

Ecuador Clinical Trial Quote Request

Ecuador Know Your Customer Form

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/CRO details (Contact Person Name, Telephone Number and E-mail Address) and RUC number (Ecuadorian Tax ID)
• No refund for policy cancellation

- CRO or Local Legal Representative must provide the completed "Know Your Customer Form"