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

Clinical Trial Application	Mongolia 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 - Premium payment is required within 14 days of receiving the invoice.