Ecuador

Ecuador

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"

Taiwan

Taiwan

Clinical Trial Application

Taiwan Clinical Trial Quote Request

Mandated Coverage

Yes

Standard Limits

n/a

Tail Coverage

n/a

Data Required to Quote

Process is slow. Please allow 2-3 weeks for receipt of documents

• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Local CRO details in English (Contact Person Name, Address, Telephone Number and E-Mail Address)
• Certificate of Incorporation of Sponsor
• Please confirm with your CRO if they require the sites to be named. If so, please provide the Site List in English, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code


- Payment is made directly by Sponsor to Carrier
- No refund for policy cancellation