Care, Custody, or Control Exclusion: Who Pays When a Rider's Wheelchair Is Damaged

What the exclusion says in your policies

Most NEMT companies carry a business auto policy and a general liability policy. The standard versions of both, which Sonoma County posts online, leave a rider’s equipment out:

• Business auto (CA 00 01 10 13), exclusion 6. No coverage for property damage to property owned or transported by the insured, or in the insured’s care, custody, or control.
• General liability (CG 00 01 04 13), exclusion j. No coverage for damage to property loaned to you, or to personal property in your care, custody, or control.

A chair damaged on the lift or inside the van usually never reaches the general liability policy at all. That form excludes injury and damage from the use of an auto you own, rent, or operate, and it counts loading and unloading as use. The step by step split between the two policies, lift included, is in general liability vs commercial auto. Whichever policy the claim lands on, the property exclusion is waiting there.

The California Department of Insurance lists care, custody, and control among the major exclusions of a general liability policy (Form 700, revised June 14, 2024). Insurers may write their own forms, so read the exclusions in yours.

The exclusion reaches property, not people. Exclusion 6 removes property damage only. A rider hurt when the chair fails is a bodily injury claim under your auto liability coverage, subject to the rest of the policy.

How it plays out on a ride

Dispatch sends your van for a 6:15 a.m. dialysis pickup. The driver loads a power wheelchair onto the lift, the platform jerks, and the chair’s joystick controller cracks against the rail. The rider is not hurt, but the chair will not drive.

1. The driver checks the rider, secures the chair, and calls dispatch. The trip gets finished or handed off the way your broker’s rules say.
2. Dispatch reports it to the broker. CareOregon’s manual (version 1.3, February 2024) names damage to a member’s mobility device during loading or securement as an incident, and wants non-injury incidents reported within 24 hours. Your broker may set its own clock.
3. The driver fills out the incident report the same day: what broke, how, photos, and witnesses.
4. You report it to both insurers before you promise anything. The standard auto and general liability forms both say that a payment or obligation you take on without the insurer’s consent is at your own cost.
5. The answers come back. Under the standard forms, the auto insurer can point to exclusion 6, and the general liability insurer to its auto exclusion and exclusion j.
6. The rider’s Medicaid program may step in. North Dakota Medicaid’s wheelchair policy (revised March 2026) covers one chair per member, with no backup chair except a one-month rental while the owned chair is being repaired. It may cover a replacement when the repair costs more than a new chair.
7. The bill can come back to you. Federal rules define a third party as anyone who is or may be liable for the cost of a member’s care (42 CFR 433.136). A state that learns of a liable third party after paying generally must seek repayment within 60 days after the end of that month, unless recovery would not be cost effective (42 CFR 433.139). See third party liability.

If your company caused the damage and has no coverage for property in its care, the repair lands on you, either from the rider directly or through the state’s recovery.

How to cover a rider’s equipment

The California Department of Insurance’s guide describes inland marine as property insurance for business property in transport that also covers the liability for damage to property in your care, custody, or control during transport. That is the description to hand your agent.

Some contracts spell out coverage for a rider’s property:

• Hamilton County, Ohio. Its request for proposals for Medicaid non-emergency transportation (KB05-25R, December 2025) lists care, custody, and control among the features your umbrella or excess policy must include. See commercial umbrella insurance for the rest of that list.
• home52, southwest Ohio. This subsidiary of the Council on Aging of Southwestern Ohio, which coordinates rides across contracted transportation companies, asks its providers for third party fidelity or similar insurance that covers a client’s loss from theft of, or damage to, the client’s property or money by any of your employees or volunteers (insurance requirements, October 2023 version).

Ask your agent these questions in writing, and keep the written answers with your policies:

1. If my driver damages a rider’s power wheelchair, scooter, walker, or oxygen concentrator while loading, securing, or driving, which of my policies pays?
2. Up to what amount for one item and for one incident, and with what deductible?
3. Does the coverage apply on the lift and at the curb, or only inside the van?
4. Does my umbrella or excess policy include care, custody, or control?
5. What proof will the insurer want after a loss, and how fast must I report it?

Your contracts matter too. A broker agreement can make you answer for damage your service causes, apart from what your insurance pays. NEMT liability covers those indemnity promises, and NEMT insurance requirements lists the policies each program asks for.

How to keep it from happening

The habits that keep riders safe also keep their equipment whole:

• Use the securement system every ride. Under 49 CFR 37.165, a van built to the federal accessibility standards uses its securement system as designed, and any other van must provide and use securement that keeps the chair in the securement area. Your staff must help riders with lifts, ramps, and securement when needed or asked.
• Secure stowed devices too. CareOregon’s manual requires mobility devices to be secured whether the rider uses the device during the ride or it is stored.
• Inspect the lift and log each check with the wheelchair lift inspection log.
• Train on chair types. The wheelchair securement guide covers tie-down points, heavy power chairs, and scooters.