Dominican Republic

Dominican Republic Clinical Trial Quote Request

Dominican Republic Due Diligence Form - Spanish (Persona Juridica)

Yes and No. Clinical Trial Insurance is not compulsory, however, it is made mandatory as part of the MoH submission.

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• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Protocol Title in Spanish
• Legal Representative in Dominican Republic or Local CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address)
• No refund for policy cancellation

Due to strict Anti-Money Laundering laws, the Legal Representative (typically your local CRO) will be responsible for providing the following documents:
(i) Due Diligence Form, available in Spanish only (to be completed by US Sponsor and each named insured, including additional insureds)
(ii) Fiscal ID certificate
(iii) Mercantile Registry
(iv) ID of the person acting on behalf of the Legal Representative
(v) Certificate of final beneficiary

Process in the Dominican Republic is SLOW, so please allow for additional time - minimum 1 month before receipt of documentation after binding coverage

Egypt Clinical Trial Quote Request
Clinical Trials Quote Request

Yes

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• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Sponsor to provide completed Know Your Country (KYC) form (Newfront to provide separately)
• Local CRO or Local Representative details (Contact Person Name and Telephone Number). If there is no local Representative, then please provide the contact details of any site/hospital participating in the trial

- Premium is paid directly to the carrier within 14 days of receipt of invoice
- No refund for policy cancellation

Policy and certificate typically take up to 3-4 weeks for carrier to process so please note this time frame in the submission process