ModivCare requires $2M liability. Your wheelchair lift isn't on the policy. Your backup driver isn't listed. One missed detail costs you the contract—or worse, a denied $500K claim.
In most programs we review, at least one of these exposures is either excluded or improperly structured.
Your vans have wheelchair lifts and stretcher mounts. You're transporting bariatric patients, dialysis patients, and hospital discharges. Your drivers work odd hours. You call in backups when someone's sick.
Most NEMT programs we audit have at least one broker-contract gap and at least one equipment-disclosure gap. These don't surface until a contract audit or a claim hits. By then, you're either scrambling to fix it mid-contract or watching an insurer deny a six-figure claim because your policy doesn't match your actual operation.
We've spent 46 years reviewing NEMT programs across Texas. Same gaps. Same broker contracts. Same wheelchair-lift modifications nobody disclosed to the insurer. Here's what your program should actually include.
Most NEMT operators don't realize they're carrying these gaps until a broker audit or claim exposes them. Here's what each coverage type prevents:
| The Scenario | Coverage That Steps In | What It Protects | The Cost If You're Exposed |
|---|---|---|---|
| Passenger Loading Liability. A solo driver attempts a two-person bariatric transfer. The patient falls and fractures a hip. Family sues for negligence. | Passenger Accident Insurance | Medical costs and liability for passenger injuries during loading, unloading, and transport. | $300K–$500K |
| Unlisted Equipment Exposure. A driver rear-ends a vehicle. The insurer discovers an undisclosed wheelchair lift modification and denies the claim because the vehicle doesn’t match the policy. | Commercial Auto with Equipment Schedule | Modified vehicles (lifts, ramps, stretcher mounts) explicitly listed and covered on the declarations page. | $400K–$600K |
| Contract Non-Compliance. ModivCare updates requirements to $2M auto liability. Your policy renews at $1M. A broker audit catches the discrepancy and terminates your contract. | Auto Liability at Contract Limits | Auto liability coverage matching broker requirements ($2M–$5M for Texas NEMT). | Loss of contract |
| Unlisted Driver Exposure. A retired backup driver covers a morning route and gets T-boned. The insurer denies the claim because he wasn’t a named insured on the policy. | Any Auto + Hired Auto Endorsements | Coverage for unnamed occasional drivers and emergency backup staff. | $100K–$200K |
| Workers’ Comp Misclassification. An auditor reviews trip logs and discovers drivers were coded as “delivery” to save premium. Reclassifies all staff retroactively to “passenger transport.” Back-premium bill arrives. | Workers’ Compensation (Class Code 7380) | Drivers coded correctly for medical transport (class code 7380) from day one. | $30K–$50K |
| Transit A&M Exposure. Passenger alleges inappropriate conduct by a driver during a 40-minute transport. General Liability caps abuse claims at $100K. Jury awards massive damages. | Abuse & Molestation (A&M) with Dedicated Limits | Dedicated $1M limit for abuse allegations, separate from general liability. | $500K–$1M+ |
If you're not sure how your policy handles these scenarios, we can walk through it with you.
Review My CoverageMedicaid reimbursement rates haven't moved in years. Gas prices fluctuate. Drivers call in sick. Broker contracts get more demanding every renewal cycle. You're squeezing pennies everywhere—and insurance feels like one more line item you're being told to accept at face value.
The problem isn't the premium—it's knowing whether the policy you're paying for will actually respond when a wheelchair transfer goes wrong or a broker audits your certificates.
We don't quote you first. We read your current policy first. We look for the gaps between how you operate (bariatric patients, backup drivers, modified vans) and what your policy actually covers. Then you decide what to fix.
Equipment schedule omissions and unlisted drivers are the most frequent triggers for claim denials in NEMT. Most operators don’t learn their policy has these structural gaps until after an accident. That’s the window we’re trying to close.
NEMT sits at the intersection of medical liability and commercial transportation — two risk categories most standard carriers underwrite separately. You're moving vulnerable passengers with documented medical needs in vehicles that may be modified, staffed by drivers with varying training levels, under contracts that specify response times and vehicle standards. That combination requires specialty market access that most generalist agents don't have.
No. The moment a vehicle is used for commercial passenger transport — even part-time — most personal auto policies exclude coverage entirely. NEMT operations require commercial auto at minimum, and depending on your contracts, may require specific limits, passenger liability endorsements, and medical payments coverage that personal policies don't provide.
Meeting the contract minimum gets you compliant — it doesn't mean you're adequately protected. Medicaid contract minimums are set to protect the state, not your business. A single serious accident involving a vulnerable passenger can generate liability well above standard contract minimums. We review what your contracts require and what your actual exposure profile demands — those are often different numbers.
Hired and Non-Owned Auto (HNOA) coverage is essential if any driver operates a personal vehicle for company business. Without it, a loss in a driver's personal vehicle during a company run has no commercial coverage response — and the driver's personal policy will likely deny the claim on commercial use grounds. This is a frequent and expensive gap in NEMT programs.
Not necessarily — but the program design matters significantly. Some carriers will write a combined program; others require separation. The bigger issue is making sure neither operation's exposures bleed into the other's policy limits. We see programs where an HHA claim erodes auto limits and vice versa. Proper program architecture prevents that.
We work with specialty markets that actually understand the NEMT risk profile — carriers like Lancer, Prime Insurance, and specialty E&S markets through Amwins, Burns & Wilcox, and RT Specialty. These are not standard commercial auto carriers. Access to the right market at submission is what determines whether you get a real quote or a declination.
30-minute call. Walk us through your operation—your vans, your brokers, your modifications. We’ll tell you exactly where your current policy breaks—and what a claim would actually cost.