India

India

India

India

Clinical Trial Application

India Specific Clinical Trial Quote Request

Mandated Coverage

Yes

Standard Limits

From 1 to 5 Million USD in aggregate

Tail Coverage

6 months (up to 1 year available for an additional premium)

Data Required to Quote

• Country-specific Application and Application must be printed and signed PRIOR to binding coverage
• Protocol and Informed Consent Form in English
• A local entity must be named as the Policyholder (Investigator or CRO)

- No refund for policy cancellation
- India requires payment to the carrier PRIOR to release of certificate

To bind coverage:
• provide Permanent Account Number (PAN) of the Local CRO. PAN number is a ten-digit alphanumeric number, issued in the form of a laminated card by the Income Tax Department
• provide Good and Services Tax (GST) number of the Local CRO

Please allow additional time for processing. Please allow at least one month before issuance of policy documents

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