The FL passenger transportation insurance market is certainly comprised of a limited group of insurance companies.  It is even further restricted for certain classes such as non-emergency medical patient transportation (NEMT). In Florida, there are two or three carriers at any one time that offer quotes for new-venture NEMT businesses.  One of the highest premium rates we typically see is for sedan/ private passenger type vehicles.  Minivans and full-size vans tend to go fare better in general.  Most preferred-tier  FL NEMT insurance companies seek a minimum of 3 years of prior commercial auto insurance to consider offering a quote.  Unfortunately, this means newly established NEMT companies must endure substantially higher premiums during those first three years.  Preferred insurance companies simply won't entertain applications from NEMT companies until they have proven themselves with three years of commercial auto insurance and demonstrated their quality of operations. As stated above, the good news is that there are solutions to insuring new venture NEMT operations in FL. When calling around for insurance, be sure to communicate clearly that your operations will involve patient transportation.  Also, let agencies know in advance of any certificates of insurance that you would be possibly needing.  Some agents are in such a hurry to provide a quote, that they may not ask all the right questions. You don't want to find yourself having paid a down payment and a payment or two on a policy to find out that your insurance agency can't issue a certificate of insurance due to a conflict with the insurance company.  This is especially possible if an applicant's business name doesn't include the words "medical, patient, care" or other patient-transport related terms.  Please contact our office via e-mail:  office@ticfonline.com, phone, FB or in person for a quote or with any questions. One of our team members would be happy to assist you.  There is also a "contact us" link on our web site for use in requesting a quote or submitting questions. Ann Marie Sikes Bessire President Transportation Insurance of Central FL, Inc. (TiCF) 3850 Curry Ford Rd St A Orlando, FL  32806 www.limoinsuranceofcfl.com Twitter: ticfinsurelimotaxi FB:  https://www.facebook.com/TransportationInsuranceOfCentralFlInc/