Slovakia

Clinical Trial Application	Slovakia Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	If sublimit, 200.000 €/patient Between 1.000.000 and 2.000.000 €/protocol
Tail Coverage	3 years after the end of patient treatment
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Slovakian • Site List in Slovakian, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code

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)