Uninsured motorist coverage on a NEMT policy: protecting riders and drivers hit by someone without insurance

What UM and UIM coverage pay for

Uninsured motorist coverage is one of the lines on a NEMT auto policy, and it steps in for the other driver’s missing liability insurance. When a driver with no policy runs a light and hits your wheelchair van, the people hurt inside cannot collect from that driver’s insurer, because there is none. Your UM coverage pays what they could have recovered from that driver, up to your UM limit. It also pays when the other driver flees and cannot be found.

Underinsured motorist coverage handles the driver who has a policy that is too small. Under the Texas statute, a vehicle is underinsured when the liability limits you can actually collect on it fall below the UIM limit on your own policy, either from the start or because other claims from the same crash used them up. As an example, if a rider’s injuries are worth $150,000 and the at-fault driver carries a $30,000 limit, UIM is the layer that can pay part of the gap.

Two details vary by state:

• Property damage. Texas includes property damage in its definition. Florida’s statute speaks of bodily injury, sickness, disease, and death.
• Insolvent insurers. Texas and Florida both treat a driver whose insurer went broke as uninsured.

Where the van itself needs repair, see loss of use and repair claims. The first hour after a crash, including the police report a hit-and-run claim depends on, is covered in the van accident guide.

Required, or rejected in writing

Most of the fight over UM happens at the moment you buy the policy. In several states the insurer must include or offer it, and the only way to drop it is a written rejection. That signature removes the protection for everyone the policy would have covered, not only the person who signs.

• Texas. An insurer may not issue an auto liability policy without UM and UIM coverage unless a named insured rejects it in writing (Insurance Code 1952.101). Once you reject it, later renewals with that insurer or one in its group stay without it until you ask in writing.
• Florida. The coverage must be on every bodily injury liability policy for vehicles registered or principally garaged in Florida. A rejection, or a choice of lower limits, goes on a form approved by the state’s Office of Insurance Regulation, headed in 12-point bold type with a warning to the buyer that the coverage being dropped is valuable. A signed form is conclusively presumed to be an informed rejection for all insureds, and the insurer must remind you of your options at least once a year (Fla. Stat. 627.727).
• Pennsylvania. Insurers must offer UM and UIM, and buying them is optional. A rejection must use the statute’s exact wording, printed on a separate sheet and signed and dated by the first named insured. A form that does not comply is void, and the policy then carries UM and UIM at the same limits as its bodily injury liability (75 Pa.C.S. 1731).
• Delaware. Each passenger vehicle of a public carrier needs $1 million of UM and UIM coverage (Title 2, section 1802). A stretcher van operator running broker trips without a public carrier certificate must still meet the public liability insurance requirements that apply to public carriers (section 1823). The Delaware guide covers that state’s other requirements.

ISO’s business auto form gives this split its own code. Symbol 6 covers only the vans you own that state law forces to keep UM coverage with no option to reject it, so a fleet garaged in a state that allows rejection may see a different symbol next to its UM line. Ask your agent to explain each symbol on your declarations page before you sign.

Drivers hurt on the job

A driver injured while working usually turns to workers’ compensation first, and UM sits beside it rather than replacing it. Florida’s statute says UM coverage pays over and above workers’ compensation benefits without duplicating them, and that it may never benefit, directly or indirectly, a workers’ compensation carrier. Whether an employee can also claim under the company’s UM endorsement depends on the policy wording and state law, so ask your agent before a claim, not after.

The business auto form adds a limit of its own: no one collects twice for the same element of loss under the liability coverage and any medical payments, UM, or UIM endorsement on the same policy. Medical payments coverage explains the no-fault medical layer that often sits next to UM.

How many drivers on the road are uninsured

About one in seven. The Insurance Research Council estimated that 15.4 percent of drivers nationwide were uninsured in 2023, and that 33.4 percent were either uninsured or underinsured, up 10 percentage points in combined rate since 2017 (February 2025 release). The state spread is wide. Mississippi had the highest uninsured share at 28.2 percent, followed by New Mexico at 24.1 percent and the District of Columbia at 23.1 percent. Maine was lowest at 5.7 percent, then Utah at 6.2 percent and Idaho at 6.4 percent.

At those rates, a fleet running hundreds of trips a week shares the road with uninsured drivers every day.

Keeping the coverage in force

UM only helps if the policy carrying it is still in force when the crash happens. HealthRide’s fleet registry keeps each van’s insurance with its expiration date, sends a reminder before it lapses, and flags an expired policy when someone assigns that van a trip.