Malaysia

Malaysia

Malaysia

Malaysia

Clinical Trial Application

Malaysia Clinical Trial Quote Request

Mandated Coverage

Yes

Standard Limits

Around 2.300.000 MYR/patient
Up to 9.300.000 MYR/protocol
75.000 MYR/each claim

Tail Coverage

1 year

Data Required to Quote

• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Local CRO or Legal Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address)
• No refund for policy cancellation

- Certificate and policy will be issued in the name of the local representative

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