Moldova

Clinical Trial Application	Moldova Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Between 5.000 and 10.000 €/patient Limit per protocol = limit per patient x number of patients
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • No refund for policy cancellation

Clinical Trial Application	Zambia Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Unknown
Tail Coverage	Unknown
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Legal representative details of the Zambia Sponsor (name, address, email, telephone number) • Hold Harmless and Claims Cut-Through Clause signed by Sponsor (to be provided separately by the carrier)