What Insurance Does an NEMT Business Actually Need?

Commonly required or expected:

• Commercial auto liability — the core policy, explicitly covering passenger transportation. Usually the largest recurring cost in the business.
• General liability — covers incidents that are not the vehicle itself, such as an injury during assistance to or from the door.
• Workers' compensation — generally required once you have employees; requirements are set by your state.
• Non-owned and hired auto — relevant if drivers ever use their own vehicles.
• Umbrella or excess liability — often the cheapest way to reach a contract-required limit.

Largest factors:

• Driver records — motor vehicle records are scrutinised closely. One poor record can move the premium for the whole policy.
• Driver age and experience — young or newly licensed drivers are expensive to add.
• Vehicle type and value — accessible conversions cost more to repair and to insure.
• Radius of operation — longer-distance work is priced differently from local.
• Claims history — including claims from before you specialised in NEMT.
• State — the same operation can be priced very differently across state lines.

Confirm each of these in writing:

• That passenger transportation for compensation is explicitly covered.
• The minimum limits your broker or payer contract requires — and that your policy meets them.
• Whether securement equipment and passenger assistance are within scope.
• What is excluded. Read the exclusions, not the summary.
• Whether the certificate of insurance can name the broker or facility as required.