Dominican Republic

Dominican Republic

Dominican Republic

Dominican Republic

Clinical Trial Application

Dominican Republic Clinical Trial Quote Request

Dominican Republic Due Diligence Form - Spanish (Persona Juridica)

Mandated Coverage

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

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 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

Peru

Peru

Clinical Trial Application

Peru Clinical Trial Quote Request

Mandated Coverage

No, but may be required by EC

Standard Limits

Provided by US Global Policy
Between 2.000.000 and 5.000.000 USD/protocol for local admitted policy

Tail Coverage

Usually 2 years for local admitted policy

Data Required to Quote

• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Protocol Title in Spanish
• Sponsor Federal ID Number (Company Registration Number) or Sponsor's FEIN
• No refund for policy cancellation

The process is slower, please allow additional time for receipt of documentation. Typical turnaround is 1-2 weeks.