Who insures it · 5 named markets · read 2026-10-28

Who insures Ambulances and non-emergency medical transportation (NEMT)?

Ambulances and non-emergency medical transportation (NEMT) is a risk most standard carriers decline on sight. The markets below say in their own published appetite or program pages that they write it; each line links to that page with the date it was read.

5 markets publicly write Ambulances and non-emergency medical transportation (NEMT): National Interstate Insurance, Prime Insurance Company, Amwins, Burns & Wilcox, RT Specialty. 3 wholesalers, 1 admitted carrier, 1 E&S carrier.

By Sam Alishahi, independent insurance broker

The markets

Who says they write it

From each market's own appetite, product or program page (or a trade article quoting it), read on the date shown. Appetites change: the linked page controls. A market listed here isn't necessarily one this agency is appointed with; a licensed broker reaches most of them directly or through a wholesaler.

Market	What they say they write	Where	Paper	Source
National Interstate Insurance Admitted carrier	Ambulance program distributed through open brokers for ambulance companies nationwide (including the MEDIC group rental captive), plus a separate NEMT and paratransit program with auto liability, auto physical damage, general liability and property. “We employ an open-broker distribution network to serve ambulance companies nationwide”	nationwide (no states listed)	not stated	natl.com · read 2026-10-28
Prime Insurance Company E&S carrier	Commercial auto for medical transport vehicles: ambulances, fully equipped ambulances traveling without lights and sirens, and non-emergency medical transportation vehicles such as wheelchair vans, medical cars and shuttle buses. “Fully Equipped Ambulances (traveling without lights and sirens)”	E&S in all 50 states; admitted commercial auto through Prime Property & Casualty Insurance Inc. in FL, IL, KS, KY, MA, NV, NJ, NM, SC; no commercial auto in NY	both	primeis.com · read 2026-10-28
Amwins Wholesaler	Transportation practice lists Paratransit/Non-emergency Medical Transport among its products, with primary, excess and inland marine capabilities. “Paratransit/Non-emergency Medical Transport”	not stated	not stated	amwins.com · read 2026-10-28
Burns & Wilcox Wholesaler	Transportation and Garage specialty lists Paratransit / NEMT among the public transportation risks it places. “Paratransit / NEMT”	not stated	not stated	burnsandwilcox.com · read 2026-10-28
RT Specialty Wholesaler	Transportation practice lists Non-Emergency Medical Transport among its targeted classes. “Non-Emergency Medical Transport”	not stated	not stated	rtspecialty.com · read 2026-10-28

Also seen: ABIS NEMT page (abiweb.com, 'writing this class of business for over 35 years') but the site calls itself an agency; Hereford (NY) lists Paratransit. Lancer and PHLY product pages fetched do not name ambulance or NEMT. The SSCL (Smart Choice) NEMT program is agent-portal only, so it could not be cited.

How Ambulances and non-emergency medical transportation (NEMT) gets placed

Standard markets first where any will look at it; when they won't, the placement goes through surplus lines, where a licensed surplus lines broker places it with an eligible non-admitted insurer and files the state's surplus lines tax and stamping forms. In California, risks on the Department of Insurance export list can go to surplus lines without the usual diligent search of admitted carriers. Surplus lines policies aren't backed by a state guaranty fund, so the insurer's financial rating matters more.

What an underwriter will want before quoting: a full description of the operation, years in business and the owners' experience, revenue or payroll, loss runs (five years where available, currently valued), the contracts or venue requirements that set the limits, and photos or safety plans where the hazard is physical.

I'm licensed in 49 states and Washington, DC and your request stays with my agency, not passed to another agent. In Florida, where my licenses are still being issued, a partner agency in your state helps in the meantime.

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