Uganda

Uganda

Uganda

Uganda

Clinical Trial Application

Uganda Clinical Trial Quote Request

Clinical Trials 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
• Legal Representative details of Sponsor ((Contact Person Name, Address, Telephone Number and E-Mail Address)
• Completed Know Your Customer (KYC) Form and Proposal Form to be provided separately
• Premium payment is due in advance of release of policy documents

No refund for policy cancellation

Chile

Chile

Clinical Trial Application

Chile 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
• Protocol Title in Spanish
• Local Legal Representative details (Contact Person Name, Address, Telephone
Number, E-Mail Address) and RUT number
• No refund for policy cancellation

Please allow 2 weeks for receipt of documents.