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

Costa Rica

Costa Rica

Clinical Trial Application

Costa Rica Clinical Trial Quote Request

Mandated Coverage

Unknown. Please confirm with your CRO.

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 Costa Rica or Local CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address)

No refund for policy cancellation