General liability insurance for NEMT companies: what it pays for and where the auto policy takes over

General liability is the policy that answers for harm your business causes when no vehicle is involved. For a NEMT company that means the office, the garage, what you say and publish, and some of the help drivers give inside buildings. Most of a ride company’s injury risk sits on the commercial auto policy instead, and the line between the two policies decides which insurer defends a claim.

This guide reads that line from the standard policy forms and two court cases. For everything a provider can be sued for, start with NEMT liability. Professional errors and abuse claims have their own guide on professional liability and abuse coverage.

What does general liability cover for a NEMT company?

It covers three kinds of claims, set out in three parts of the commercial general liability (CGL) form published by ISO, CG 00 01. The California Department of Insurance calls the CGL the standard commercial liability policy used to insure businesses. The 04 13 edition is quoted here; your declarations page lists the edition your insurer uses.

• Coverage A, bodily injury and property damage. The insurer pays damages for injury or property damage that an occurrence causes, and the form defines an occurrence as an accident, including continuous or repeated exposure to the same harmful conditions. The insurer also takes on your defense in any suit asking for those damages. Example: a rider’s daughter slips on a wet floor in your dispatch office.
• Coverage B, personal and advertising injury. This part covers listed offenses rather than accidents: false arrest, detention or imprisonment; malicious prosecution; wrongful entry or eviction; publishing material that slanders or libels a person or disparages a business; publishing material that violates a person’s right of privacy; using another’s advertising idea; and infringing copyright, trade dress or a slogan in your ads.
• Coverage C, medical payments. It pays reasonable medical bills regardless of fault for injuries from an accident on premises you own or rent, on the ways next to them, or because of your operations, if the expenses are incurred and reported within one year. It pays nothing for injuries to an insured (volunteer workers aside), and nothing Coverage A excludes.

One detail matters for ride companies. Coverage B has its own list of exclusions, and the auto exclusion is not on it. A false detention claim is not knocked out of Coverage B just because it happened in a van, although Coverage B’s own exclusions, such as knowing violations of another’s rights and criminal acts, still apply.

Where does the auto policy take over?

At the vehicle. Exclusion g of the CGL takes out bodily injury and property damage that comes from owning, maintaining, using or entrusting to others any auto “owned or operated by or rented or loaned to any insured.” It then adds: “Use includes operation and ‘loading or unloading’.” Under the CGL’s definitions, machinery or equipment attached to a vehicle is treated as part of the auto, which puts a van’s lift or ramp inside the exclusion.

The business auto form, CA 00 01, starts where that exclusion ends. It pays for injury or damage that an accident causes and that results from owning, maintaining or using a covered auto. What the general liability form drops at the van, the auto form picks up.

The 04 13 edition also closes an argument plaintiffs try. The auto exclusion still bites when a lawsuit alleges negligent supervision, hiring, employment, training or monitoring, as long as the occurrence involved an auto the insured owned or operated. A lawsuit blaming your hiring of a driver with a poor record for a crash is still an auto claim.

Contract promises split the same way. The CGL covers tort liability you take on in a business contract, which it calls an “insured contract,” but its auto exclusion gives that back only for aircraft and watercraft. Indemnity you promise a broker for crashes therefore leans on your auto policy, which the guide to NEMT insurance exclusions explains.

Who pays when a rider falls from the lift?

Usually the auto insurer, but the facts decide. Two cases show where courts have drawn the line.

The dialysis trip in Louisiana. In July 2010, staff at a nursing home in Tallulah, Louisiana rolled a resident’s wheelchair onto a van lift for a ride to dialysis. The chair rolled off the raised platform and she struck her head on the pavement. The family sued the facility, its auto insurer and its general liability and long-term care insurer. The auto insurer settled, for $750,000 according to the other insurer. Against the general liability policy, the family argued that choosing the wrong wheelchair and having no second staff member were negligence separate from the van. In February 2017, Louisiana’s Second Circuit Court of Appeal applied the policy’s auto exclusion anyway. Boarding and leaving a vehicle, the court wrote, is “an inevitable and integral part of operating it.” It also rejected the family’s reading that, because the policy defines loading as handling property, boarding a person falls outside the exclusion.

The church parking lot in Georgia. In February 2016, a personal care home’s van took residents to church. While others were being strapped in, a church volunteer parked one resident’s wheelchair in a sunny spot behind the van and did not set the brakes. The chair rolled across the lot into a curb and she fell. This time the van’s auto insurer refused to cover the lawsuit. In August 2020, a federal court in Atlanta agreed: she was not in the process of boarding, she was placed there to keep warm, and her injury was too remote from any use of the van. The court also held that the home and its driver had not given the auto insurer timely notice, a second reason the insurer owed nothing.

Read together, the cases point to three habits:

1. Report every rider injury to both insurers the same day. Let them sort out which policy answers. Late notice cost the Georgia home its coverage on its own.
2. Record where the rider was and what the driver was doing. Both courts decided the case on those two facts.
3. Check that your limits match on both policies. A claim can land on either one, so a low general liability limit is not safe just because most injuries happen at the van.

Claims that stay on the general liability policy

Anything with no real tie to driving, boarding or unloading belongs here.

• Your office and garage. Falls in a waiting area, a visitor tripping over a charging cable, a contractor hurt in your lot. Coverage C can pay small medical bills without anyone suing.
• Fire in space you rent. The form says its exclusions c through n, the damage-to-property exclusion among them, do not apply to fire damage to premises rented to you, and it carries a separate Damage To Premises Rented To You limit for that. If a fire you cause damages a leased office or garage, this is the coverage that answers the landlord.
• Help inside a building. A driver walking a rider down a clinic hallway is further from the van than the Louisiana lift and closer than the Georgia parking lot. Where such a fall lands depends on the facts and the wording, and a professional liability policy may respond as well.
• What your staff say and publish. Coverage B offenses, such as a former driver suing over a company post that called him a thief, belong here. A data breach of rider records is a different risk; see cyber insurance for NEMT.

What general liability leaves to other policies

Several common NEMT losses sit outside the CGL, each covered elsewhere:

• Injuries to your own employees. The employer’s liability exclusion sends them to workers’ compensation; see workers’ comp for NEMT.
• Property in your care, custody or control. Exclusion j(4) removes personal property your company holds that way, which is why a rider’s wheelchair damaged on board is rarely covered. The guide on a wheelchair damaged during transport covers what does respond.
• Cars your staff drive for errands. Employees are insureds under the CGL while doing your work, so a car one of them drives on a company errand falls under the auto exclusion. That gap is filled by hired and non-owned auto coverage.
• Abuse allegations. Insurers can attach abuse or molestation exclusions by endorsement; check your forms list against the abuse and molestation coverage entry.

How much general liability do contracts require?

The CGL has six separate limits, and contracts usually name the first two. The each occurrence limit caps what is paid under Coverages A and C for any one occurrence. The general aggregate caps everything paid in a policy year under Coverages A, B and C, except products and completed operations. The other four are the products and completed operations aggregate, the personal and advertising injury limit, the Damage To Premises Rented To You limit, and the medical expense limit per person. The limits reset for each annual period.

Published NEMT requirements show what buyers expect:

• SafeRide Health: $1 million for any one occurrence, a $2 million aggregate, and SafeRide named on the certificate as an additional insured.
• Verida, Georgia human services transportation: the same $1 million and $2 million, written on an occurrence basis with contractual liability included, and Verida and the State of Georgia added as additional insureds.
• home52, Ohio: an occurrence limit of $1 million and an annual aggregate of $2 million, and both home52 and the Council on Aging of Southwestern Ohio as additional insureds. An agency running six or more vehicles must add a $1 million umbrella, which it can skip by carrying general liability limits of $2 million and $4 million instead.

Other programs set general liability lower or higher, and some add requirements on top. The professional liability guide compares more contracts side by side, and umbrella insurance explains how an umbrella can make up the difference when a contract asks for more than your primary limit.

How general liability is priced and audited

Your premium starts from a classification code for your type of business. In the California Department of Insurance’s guide, the rating base for general liability can be your square footage, your payroll or your gross sales, whichever one your classification code uses, and the premium is the rate times that exposure. A higher deductible lowers the rate.

The premium on your declarations is only a deposit. Under the CGL’s premium audit condition, the insurer works out the earned premium when each audit period closes, bills or refunds the difference, and expects you to keep the records it needs. If a new broker contract will grow your receipts mid-year, tell your agent before the auditor finds it; the premium audit guide covers what auditors count and how to dispute a bill.

Trip records for claims between two policies

Whether a rider was boarding the van or waiting near it can decide which insurer pays. HealthRide stores when every ride started and ended, the miles recorded by GPS and any signature captured on screen, and every change is recorded. The driver’s pre-shift van inspection is done in the app and saved with the shift. The reports page shows how the trip log exports when an insurer asks.