Ethiopia

Clinical Trial Application	Ethiopia Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Unknown. Please confirm with CRO if local admitted clinical trial insurance is required.
Standard Limits	Unknown
Tail Coverage	Unknown
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Local CRO details (Contact Person Name, Telephone Number and E-mail Address) • Premium payment is due and payable in advance of receiving policy documents • No refund for policy cancellation

Clinical Trial Application	Indonesia 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 • Site List in English, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code • Local Representative/CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address) - Premium payment and payment confirmation required PRIOR to release of certificate - No refund for policy cancellation Please allow additional time for processing