Tanzania

Tanzania

Tanzania

Tanzania

Clinical Trial Application

Tanzania Clinical Trial Quote Request

Clinical Trials Quote Request

Mandated Coverage

Yes

Standard Limits

n/a

Tail Coverage

n/a

Data Required to Quote

THE PROCESS IN TANZANIA 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.

• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Certificate of Incorporation of Sponsor
• Sponsor Business License
• Tax Identification Number (TIN) number (FEIN will suffice)

- Premium payment required in advance of receipt of policy documents
- No refund for policy cancellation

Indonesia

Indonesia

Clinical Trial Application

Indonesia 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
• Site List in English, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code
• Local Representative/CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address)

- Premium payment and payment confirmation required PRIOR to release of certificate
- No refund for policy cancellation

Please allow additional time for processing