Portugal

Clinical Trial Application	Portugal Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	100.000 €/patient 2 to 5.000.000 €/protocol
Tail Coverage	2 years
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Portuguese • Tax Identification Number (TIN) of the sponsor • Site List in Portuguese, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code

Clinical Trial Application	Pakistan 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 • Local CRO/Legal Representative details (Contact Person Name, Address, Telephone • Number and E-Mail Address), Tax Number and Sales Tax Number The Legal Representative is responsible for providing the following: • Tax number and sales tax number • Board resolution for insurance purposes • List of members/directors • Identity document of the person authorized to deal with the insurance carrier - Pakistan requires payment and wire payment confirmation PRIOR to release of documentation - Sponsor pays the carrier directly once invoice is provided - No refund for policy cancellation Quote process is VERY slow in Pakistan due to fronting and reinsurance carriers. Submission should be made to Newfront at least 45 days before documents are required.