Trades / Ambulance services
NAICS 62191 · high injury risk
Insurance for ambulance services
Ambulance services log 5.9 recordable injuries and illnesses per 100 full-time workers, 157 percent above the private-industry figure of 2.3 and number 5 of the 54 trades on this site. That record is what an underwriter sees first, and it is why the checklist below leans on workers' compensation and liability limits.
- 1Ambulance services 5.9 per 100
- 2Private industry 2.3 per 100
- 3Rank of 54 #5
What goes wrong in this trade
Crashes while running with lights, lifting injuries to crews, and malpractice claims over treatment in transit.
The checklist for ambulance services
- AutoCommercial auto liabilityAmbulances on emergency runs.State minimum auto liability applies to business vehicles. Interstate for-hire carriers of vehicles 10,001 lb GVWR and up must carry the 49 CFR 387.9 minimums ($750,000 non-hazardous property; $1,000,000 oil; $5,000,000 bulk hazmat).
- E&OProfessional liability (E&O)Medical malpractice for care given by EMTs and paramedics.Not required by federal law; some state licences and client contracts require it.
- WCWorkers' compensationRequired once you have employees in nearly every state.Required by state law in nearly every state once you have employees; the employee-count threshold and exemptions are set state by state and are not reproduced here.
- GLGeneral liabilityPremises and non-medical claims.Not required by federal law. Required in practice by most contracts, landlords and many state contractor licences.
- AbuseAbuse and molestation liabilityPatients are vulnerable adults and children.Not required by law; often required by state licensing or clients for care providers.
- UmbrellaCommercial umbrella / excessSerious crash claims can exceed auto limits.Not required by law; required by many general contractors and commercial landlords.
Red tags mark policy types that a law or licence usually requires; green tags are what contracts, landlords and clients ask for. Tailor the list for your situation (no employees, no vehicles, alcohol) with the checklist tool.
What the injury record means for the premium
Workers' compensation is rated on payroll and class, then adjusted by your own loss history, so a trade with 5.9 cases per 100 workers starts from a high base rate before an underwriter has looked at you. Worse, 63 percent of those cases involved days away from work, restriction or transfer — the expensive kind. The practical consequence: a documented safety programme and a clean experience modifier are worth more here than shopping carriers.
The nearest trades by injury rate are pet grooming and boarding (5.8), carpet and upholstery cleaning services (5.6), nursing care facilities (6.3); the same payroll insured in those classes would start from a similar workers' comp base.
Legal, licence or contract?
Fixed by law
- Workers' compensation once you have employees, in nearly every state (threshold and exemptions set by the state; not reproduced here).
- State minimum auto liability on any vehicle the business operates.
Asked for by contracts and licences
Sources: BLS Survey of Occupational Injuries and Illnesses, Table 1 (2024), incidence rates per 100 full-time workers; BLS SOII Table 3 (2024), hours worked by detailed industry; BLS Census of Fatal Occupational Injuries, Table A-1 (2024). Fatal rate per 100,000 FTE is derived (count ÷ hours × 200,000,000) and approximate. Checked 2026-10-24.