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

Mexico

Mexico

Clinical Trial Application

Mexico Clinical Trial Quote Request

Mandated Coverage

Yes

Standard Limits

n/a

Tail Coverage

n/a

Data Required to Quote

THE PROCESS IN MEXICO IS SLOW. PLEASE ALLOW UP TO TWO MONTHS FOR DOCUMENTS TO BE PROCESSED. Please provide all documentation outlined below otherwise the process is further delayed.

PLEASE PROVIDE THE FOLLOWING INFORMATION
• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English and Spanish
• Protocol Title in Spanish
• The following documents to be provided by the Sponsor:
(i) Copy ID of the legal representative of the Sponsor (this should be the same as the person completing the form)
(ii) Proof of address of the sponsor (not older than 3 months)
(iii) Document confirming the legal establishment of the sponsor --->
Legal representative details of the Sponsor in Mexico
Note the Legal Representative will be responsible for providing the following documents:
(i) Copy of the Memorandum of Association registered upon the Property & Commerce Public registry
(ii) Copy of the Fiscal Identification Schedule (RFC)
(iii) Copy of an Official Identification and Notary’s Testimony of the local CRO
(iv) Copy of a Domicile Voucher