Should social workers drive clients in their own cars? Insurance, agency policy, and safer options

The short answer

Whether you may drive clients is your agency’s call, but much of the insurance risk lands on you. Under the standard business auto form written by the Insurance Services Office (ISO), your employer’s coverage for cars it does not own is excess over any other collectible insurance, and the form does not make an employee an insured while driving a car the employee owns. In a crash with a client on board, your personal auto policy is usually the first one asked to pay.

Before the next client ride, settle three things: what your own policy says about work driving, what your agency’s policy and coverage say, and whether the client could get a Medicaid ride instead.

Your personal policy is usually first in line

Personal auto rates depend partly on how you use the car. The Texas Department of Insurance tells drivers their rates will be higher if they drive to work or use the car for business. An insurer that does not know you drive clients for your job has not priced that risk, and a claim is the worst time for it to find out.

The bigger question is whether a policy excludes the trip. In a notice to rideshare drivers, California’s insurance department warns that standard personal policies mostly carve out livery, its term for carrying people for hire. The sample wording it quotes excludes coverage while the vehicle “is being used as a public or livery conveyance.” A caseworker driving a client to a court date or a clinic is not running a taxi, and at least one court has drawn that line.

In 2014, the Fifth Circuit applied Mississippi law to a “carry persons for a charge” exclusion in State Farm v. LogistiCare Solutions. It relied on an earlier case holding that the exclusion did not apply to an employee using his own car for work and reimbursed by his employer on a mileage basis, because he was not profiting from the reimbursement. Under Mississippi law, the court said, the exclusion bars coverage only when the passenger pays the driver or a third party pays more than reimbursement. It ruled the other way for a volunteer Medicaid ride driver who was paid by a set route regardless of the road she took and could stack per-member mileage pay when she carried several riders, finding she profited beyond reimbursement. Policy wording and state law differ, so ask your insurer, in writing, whether the policy covers you while driving clients for work.

Damage to your own car is a separate problem. Non-owned auto coverage on a business policy is liability coverage: it pays for harm to others, not for repairs to the worker’s car, so those go to the worker’s own collision coverage and deductible.

What your agency’s coverage does

An agency whose staff drive their own cars for work can carry hired and non-owned auto coverage, which protects the agency when someone sues it over an employee’s driving. One reason employers buy it is that they can be held responsible for an employee’s negligence on the job. California’s Civil Code section 2338 is one example: a principal is responsible to third persons for an agent’s negligence in the agency’s business.

That coverage protects the organization, not you, and under the standard form it pays after your own policy. Ask your agency three questions: does it carry non-owned auto coverage, at what limit, and does it reimburse your deductible if you crash on a work trip.

Public employers can work differently. Texas’s State Office of Risk Management runs an auto program for state agencies. Its hired and non-owned coverage protects agencies whose employees drive their own cars in the course of their work. Because state employees’ personal policies are not considered collectible under Texas law, the program does not treat itself as excess over them. The program will not pay for damage to the employee’s own car, and the employee reports the accident to their personal insurer while the agency reports it to the state. It does answer claims from passengers in the car who are not employees, to the extent the driver is legally liable. County and city agencies elsewhere may have their own risk pools with their own terms, so ask for the written policy.

What NASW’s safety guidance asks

The National Association of Social Workers’ Guidelines for Social Work Safety in the Workplace (2013) devote standard 7 to transporting clients. It says that when transporting clients is part of the job, employers should have policies and practices that protect both the worker and the client.

At pickup, the guidance asks the social worker to assess:

• The client. Any agitation, use of alcohol or drugs, and what the appointment means to the client.
• Weapons. The possibility that the client is carrying one.
• Their own read. The worker’s own sense of whether the ride is safe.

It then asks about the car:

• Loose objects. The interior should be clear of things that could be used as a weapon, such as pens, pencils, magazines, books, handheld devices, and hot drinks.
• Condition. Enough fuel, working brakes, and working headlights and tail lights.
• Emergency gear. Flares, battery cables, and a spare tire.

For children, the guidance adds three steps: engage the child safety locks, know how to install a child safety seat that fits the child’s age and size, and use a buddy system with a second social worker in the car. If the client or the vehicle is judged unsafe, it says agency policy should prohibit the ride.

Standard 8 covers the trip itself. Before field visits, the worker should leave the office the visit addresses and times in order, information about the clients, the expected length of each visit, the vehicle’s license number, make, model, and color, and any change of plans.

Mileage: what the worker gets and what Medicaid pays

Your agency’s policy sets your mileage reimbursement, and the IRS business rate is the federal reference point. Under the federal wage rule at 29 CFR 778.217, an employer’s travel reimbursement at or below the IRS figure counts as reasonable and stays out of the regular rate used to figure overtime. The IRS rate began 2026 at 72.5 cents per mile and rose mid-year to 76 cents for miles driven from July 1 through December 31. The separate IRS charity rate, unchanged at 14 cents per mile, is meant for volunteers, not employees. Our mileage reimbursement entry covers how ride programs pay mileage to members and families.

Medicaid has a code for the client’s ride when a caseworker drives. HCPCS A0160 is “Non-emergency transportation: per mile - case worker or social worker.” Not every state lists it. Arizona’s Medicaid program pays it at $0.44 a mile in both urban and rural areas, effective October 1, 2026. Whether your agency can bill it depends on how the state enrolls providers for that code.

The worker’s own travel is a different matter. CMS’s 2023 transportation guide says the cost of travel by a provider, including case managers or nurses making home visits, is not coverable under Medicaid’s transportation assurance. That benefit exists to get the member to care.

Volunteers who drive clients

Federal law gives volunteer drivers little protection for crashes. The federal Volunteer Protection Act limits a volunteer’s personal liability, but it does not cover harm caused by operating a vehicle the state requires to be licensed or insured, and it leaves the nonprofit’s or agency’s own liability where it was.

California protects the volunteer’s insurance instead. Insurance Code section 11580.1(f) bars personal auto policies from excluding volunteer driving for a nonprofit or government agency that provides social service transportation, meaning rides for seniors or for people with special transportation needs because of physical or mental conditions. Insurers may not cancel a policy for that driving, and section 11580.25 bars classifying the car as for-hire because of it. The protection ends if the volunteer is paid anything beyond reimbursement for actual miles at a rate capped by state rules. Our guide to volunteer driver programs covers screening, mileage, and insurance for programs that rely on volunteers.

When booking a ride is the better choice

A booked ride takes the liability off your car and can get the client a vehicle built for their needs. Consider it first in these cases:

• The client has Medicaid and the trip is to covered care. Under 42 CFR 431.53, every state must make sure members who have no other way to get there reach their medical appointments. Our guide to booking a Medicaid ride for a patient walks through the call.
• The client uses a wheelchair. CMS’s coverage guide tells states that a wheelchair user’s Medicaid ride has to come in an accessible vehicle.
• NASW’s warning signs are present. Agitation, intoxication, and a possible weapon are what the guidance asks you to check, and a client judged unsafe should not ride.
• The client is a child and you lack the right car seat. The guidance asks for a seat that fits the child’s age and size.
• The trip repeats. Weekly therapy or three-times-a-week dialysis is better set up as a standing ride than handled by one worker’s schedule.

Questions to settle with your agency

1. Does agency policy allow staff to drive clients in personal cars, and for which clients and trips?
2. Does the agency carry hired and non-owned auto coverage, and at what limit?
3. Will the agency reimburse your deductible after an accident on a work trip?
4. What minimum personal auto coverage does the agency expect you to carry?
5. What mileage rate does the agency pay, and how do you document miles?
6. Is a second worker required for child or high-risk transports?
7. Who books Medicaid rides for clients, and how far ahead?

Get the answers in writing and keep them with your insurer’s reply about work driving.

For the ride companies agencies call

Caseworkers who book rides for clients need to know the pickup happened without calling around. A ride company on HealthRide can set an agency up with its own portal to book rides, watch each one on a live map, and pay its bill online. Rides the agency covers are priced from its rates and gathered onto its invoice from the completed trips.