Lights, sirens and the care in the back.
Commercial auto for emergency and interfacility units, medical professional liability for EMTs and paramedics, abuse coverage and workers' comp for private ambulance companies.
By Sam Alishahi · CA Insurance License #4348151 · Reviewed September 2026 · How this page is researched
Two exposures on every call
An ambulance company carries two risks that most fleets do not share: emergency driving, with the crash exposure that comes with running code, and patient care by EMTs and paramedics while the unit is moving. The auto policy answers for the first; medical professional liability answers for the second.
Few transportation programs accept emergency work. The one I use that will consider ambulances starts at 2 units, pulls a motor vehicle record on every driver through its own portal, and wants 3 years of loss runs with no gaps. Crew licenses should be issued in the state where the units are based.
- Commercial autoEmergency and interfacility units, with physical damage.
- Medical professional liabilityCare by EMTs and paramedics en route.
- Abuse and molestationPatients who cannot protect themselves.
- Workers' compCrews lifting patients and riding in the back.
What underwriters will ask
Having these ready means I can go to market on the first call. The quote form asks for the same things, and anything you don’t know yet can wait.
- Units: year, make, model, BLS or ALS, and value for each ambulance. The program starts at 2 units.
- Crews: drivers and attendants with license state and number; a motor vehicle record is pulled on each driver.
- Work mix: 911 response, interfacility transfers, standby events and any non-emergency trips.
- Permits: county EMS agency permit and state licensing.
- Revenue and payroll: annual figures.
- History: 3 years of loss runs with no gaps, or since the company started.
Ambulance insurance, answered
Do EMTs need their own malpractice coverage?
The company policy should carry medical professional liability that covers the crews as employees. Individual policies are rare; I check that the company form names them.
Is emergency driving covered like any other auto risk?
It is rated harder. Most transportation programs refuse emergency work, so an ambulance fleet goes to the market that accepts it, with motor vehicle records on every driver.
Can I mix wheelchair vans and ambulances on one policy?
Often, when one program writes both. The non-emergency units are rated as NEMT and the ambulances as emergency work.
What history do underwriters want?
Three years of loss runs with no gaps in coverage, or runs since the company started if it is younger than that.
Do you offer ambulance company insurance outside California?
Yes. Clients across the country send the same quote form. Sam Alishahi is licensed in 49 states and Washington, DC and places policies there directly. In Florida, where Sam's licenses are still being issued, a partner agency in your state helps in the meantime. The shopping across carriers works the same way. Rules, minimums and markets differ by state — see truck insurance by state or insurance requirements by state.
Send your unit list. I'll shop it.
Units, crews and your county permit are enough to start.
Alishahi Insurance · Saman Alishahi, independent insurance broker, California License #4348151. General information, not a quote or a promise of coverage; coverage depends on underwriting and the terms, conditions and exclusions of the policy actually issued.
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