Paratransit Insurance Application | First Underwriters Insurance Brokers

Medical transportation insurance · Since 1992

Paratransit Insurance Application

Specialized coverage for paratransit and non-emergency medical transportation — passenger liability, wheelchair securement, and NEMT compliance. Complete the application below for a customized quote.

🏆 34+ years protecting PNW paratransit operators ⭐ A-rated carriers 🚐 Medical transportation specialists

Paratransit Insurance Quote Application

Why complete this application?

Completing this paratransit insurance application lets you receive a customized quote for your medical transportation operation. Our specialists understand the unique risks paratransit coverage must address.

What our paratransit insurance covers

We address passenger liability, wheelchair securement, and NEMT compliance requirements, working with top-rated carriers to provide comprehensive coverage at competitive rates. Learn more about commercial auto insurance options for your fleet.

How to complete this form

Gather your business documentation, vehicle list, driver information, current policy details, and claims history before you begin. Please allow about 15–20 minutes to complete the full application.

Explore our other transportation insurance solutions:

Trucking Insurance Towing Insurance Commercial Auto All Business Insurance

⚠️ Notice for paratransit insurance applicants Any person who knowingly files an application containing materially false information — or who conceals facts material to the application — commits a fraudulent insurance act. Such actions are crimes that subject the person to criminal and civil penalties, and may result in denial of coverage. Providing accurate information ensures your quote reflects your actual coverage needs; all information provided is verified.

📋 Applicant Information

Please provide your business details below. Accurate information helps us provide the best paratransit insurance quote. Fields marked with an asterisk are required.

Named Insured (Legal Business Name) *

Search Google to find your business and auto-fill your address

Business Location & Address

Address *

City *

State *

ZIP Code *

Business Experience & History

Years in Business *

Years in Paratransit Business *

Years Under Current Ownership

Contact Information

Phone *

Website

FEIN (Federal Employer ID Number) *

Insurance Contact Name

Contact E-Mail *

What is the primary purpose of your paratransit operation, and how are services provided? *

🏢 General Information

This section gathers information about your business structure, current insurance coverages, and premium history for accurate quoting.

Business Structure & Entity Type

How would you describe your paratransit operation? *

If Other, please describe:

Current Insurance Coverages & Filings

Do you currently have the following coverages in place?

General Liability

Professional Liability

Workers Compensation

Umbrella/Excess

Are any filings required for your paratransit insurance?

Yes

If yes, please provide filing entity and number:

Does the ownership/management operate or have an interest in any other transportation businesses?

Yes

If yes, please describe:

Business Ownership & Operating History

How long has this organization operated under the present name?

List all subsidiary and/or prior names under which business was operated:

Insurance & Premium History

Year	Insurance Company	Auto Liability Premium	Physical Damage Premium	PD Total Insured Value	General Liability Premium	Annual Revenues	Total Trips
Proposed Year
Expiring Year
Expiring Year +1
Expiring Year +2
Expiring Year +3
Expiring Year +4

Target Pricing & Policy History

Target paratransit insurance pricing per unit for the proposed year:

In the past 3 years, have any Auto Liability policies been canceled or non-renewed?

Yes

If yes, please explain:

🚐 Operations Details

This section covers your service areas, operations breakdown, client demographics, and subcontracting details.

Service Areas — cities where you provide paratransit services

City 1

% of Operations

City 2

% of Operations

City 3

% of Operations

City 4

% of Operations

Operations Breakdown (percentages must total 100% in each category)

Type of Transport

Non-Emergency

Emergency

Other

Type of Service

Wheelchair

Stretcher

Ambulatory

Service Provided

Curb to Curb

Door to Door

Door thru Door

Service Arrangements

Pre-Scheduled

On-Demand

Fixed Route

Radius of Operations

0–50 miles

50–200 miles

200+ miles

Description of OTHER transport type, if applicable:

Client Demographics & Special Transport Needs

Clients 18 or younger (%)

18 to 60 years old (%)

Older than 60 (%)

Will you be transporting any pregnant women?

Yes

Do you administer any anesthesia?

Yes

Do you transport any patients against medical advice?

Yes

Do you transport passengers with oxygen tanks?

Yes

If Yes, how are tanks secured during transit?

Revenue Sources & Dispatch Methods

Are any revenues generated from non-transportation activities?

Yes

If Yes, please explain:

Is any work dispatched by a TNC (Uber, Lyft, etc.)?

Yes

Do you ever transport passengers using rented vehicles?

Yes

🚌 Vehicle Information

Please provide details about your paratransit vehicle fleet, usage policies, and maintenance records below.

📎 Upload your Vehicle and Driver List/Schedule * Upload your complete vehicle and driver schedule (PDF, Word, or Excel format)

Required information: Please include year, make, model, VIN#, passenger capacity, and wheelchair/stretcher capability for all vehicles, plus driver names, license numbers, and experience levels.

Vehicle Count by Year and Type

Year	Vans (1–8 Passenger)	Mini-Van/Bus (9–20 Passenger)	Buses (20+ Passenger)	Private Passenger/Service
Proposed Year
Expiring Year
Expiring Year +1
Expiring Year +2
Expiring Year +3
Expiring Year +4

How many vehicles are equipped with Lifts?

How many vehicles are equipped with Ramps?

Vehicle Usage & Registration Policies

Are drivers allowed to take paratransit vehicles home?

Yes

If Yes, is any personal use allowed?

Yes

Is any family member usage permitted?

Yes

Are vehicles used for any purpose other than transporting passengers for hire?

Yes

If yes, please explain:

Vehicle Titling & Registration

Are all vehicles titled and registered to the named insured?

Yes

If no, is there a lease agreement between the Named Insured and the vehicle owner?

Yes

Are all vehicles registered in the state in which they operate?

Yes

Vehicle Maintenance & Safety Equipment

Do you have a written vehicle maintenance program?

Yes

How often are vehicles serviced?

Who provides maintenance on your vehicles?

How often are maintenance records reviewed by management?

Are all wheelchair vehicles equipped with forward-facing, 4-point tie downs?

Yes

Are any vehicles equipped with lights and/or sirens?

Yes

If yes, please describe circumstances when they are used:

👥 Employee & Driver Information

This section covers your staffing, hiring criteria, and driver training programs, which significantly impact your paratransit insurance rates.

Are all paratransit drivers employees?

Yes

Staff Count

Full-Time Drivers

Regular Part-Time Drivers

Back-Up Drivers

Dispatchers

Maintenance

Administrative

Are all persons involved with wheelchair transportation instructed in the proper use of securement equipment for all types of wheelchairs?

Yes

How often do you order MVRs?

Annual driver turnover (%)

Do you have driver hiring criteria in place?

Yes

If yes, is the criteria in writing?

Yes

Additional Driver Training & Background Checks

Road test given prior to hire

Yes

Orientation in vehicle with experienced driver

Yes

If yes, how long?

Criminal Records Check / CORI Check

Yes

If yes, which type?

State

Federal

Describe your standards for an acceptable MVR (or attach a copy of your driver hiring criteria):

🛡️ Safety & Claims Management

This section addresses your safety protocols, accident review procedures, and claims management.

Claims Reporting Contact

Name/Title

E-mail

Phone

Safety Training Contact

Name/Title

E-mail

Phone

Accident Review & Driver Monitoring

Describe your accident review procedures:

How many vehicles are equipped with Accident Event Recorders or Cameras?

Name/brand of the AER Units / Cameras in place:

Where do cameras record?

Interior

Exterior

Both (dual facing)

How is data reviewed?

Third Party

Internal

If internal, who is responsible?

Are MVRs checked on all drivers at least annually?

Yes

Minimum years of driving experience required:

Is there a driver incentive program in place?

Yes

If yes, please describe:

Safety Procedures & Policy Coverage

Is there a post-accident drug testing policy in place?

Yes

Do you have a "bus empty" procedure?

Yes

If yes, please describe:

How does your current Auto Liability policy address claims arising from loading and unloading patients?

Silent

Excluded

Sublimit

If Sublimit, please specify the amount:

⚖️ Professional Liability

This section covers professional liability history and any claims or potential claims for your paratransit operation.

Claims & Malpractice History

Has any claim or suit for an error, omission, or malpractice ever been made against the applicant, the organization, or any employees/staff working on the applicant's behalf?

Yes

If Yes, how many? Please complete a supplemental form for each claim.

Are you or any proposed insured aware of any claim or suit, or any act, error, omission, fact, circumstance, or records request from an attorney which may result in a malpractice, general liability, or products liability claim or suit?

Yes

If Yes, has each of these been reported to the current or any prior insurer?

Yes

If Yes, how many? Please complete a supplemental form for each.

Has anyone on staff:

Ever been the subject of disciplinary/investigative proceedings or reprimand by a governmental/administrative agency, hospital, or professional association?

Yes

Ever been convicted for an act committed in violation of any law or ordinance other than traffic offenses?

Yes

Ever been treated for alcoholism or drug addiction?

Yes

📚 Helpful paratransit insurance resources

While completing your application, you may find these industry resources helpful for understanding regulations and best practices.

Applicant agreement & signature

By signing this paratransit insurance application, I certify that the information provided is true and complete to the best of my knowledge. I understand that any misrepresentation or concealment of facts may result in denial of coverage and could void any policy issued.

Applicant's Typed Signature *

Date *

Review all information above for accuracy and ensure all required fields are completed. You'll receive a confirmation email, and our team will contact you within 72 hours.

Our paratransit insurance team will review your application and contact you within 72 hours. Please have your vehicle and driver information ready for follow-up questions.

Explore more transportation insurance solutions

First Underwriters offers comprehensive coverage for transportation businesses of every size, including hard-to-place risks, with personalized service for every client.

🚛 Trucking Insurance

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🚗 Towing Insurance

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🚐 Commercial Auto

Business vehicle coverage solutions

👷 Workers' Compensation

Protect your employees and business

Questions about your paratransit insurance application?

Our paratransit insurance specialists are here to help you get the coverage you need. We understand the unique challenges of medical transportation operations and work with top-rated carriers to provide comprehensive coverage.

📞 Call (425) 242-5357 ✉️ Email us

Free consultation · Same-day quotes available · No obligation

This application collects information used to prepare a paratransit insurance quote and does not itself bind coverage or constitute an offer; coverage, limits, and eligibility are governed by the terms, conditions, and exclusions of any policy issued and are subject to underwriting. First Underwriters Insurance Brokers · Kirkland, WA · (425) 242-5357.

First Underwriters has served Pacific Northwest businesses since 1992, specializing in commercial transportation insurance including trucking, paratransit, and commercial auto coverage. Your information is kept secure and confidential.

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