Indonesia

Indonesia

Indonesia

Indonesia

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

Belgium

Belgium

Clinical Trial Application

Belgium Clinical Trial Quote Request

Clinical Trials Quote Request

Mandated Coverage

Yes

Standard Limits

Between 400.000 and 600.000 €/patient
Between 3.000.000 and 5.000.000 €/protocol

Tail Coverage

3 years

Data Required to Quote

• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Protocol Title in French
• Local EU Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address). Not required if Sponsor is domiciled in the EU.