# Insurance for ambulance services, patient transport and medical driving services in Germany

> An ambulance service combines two expensive risks: vehicles that have to get through traffic under blue lights, and patients who must arrive safely on a stretcher or carry chair. Add defibrillators, ventilators and a team doing heavy physical work. This page explains which insurance is compulsory in Germany, what it costs and where gaps open up.

Quelle/Source: https://www.nammert.com/en/business-insurance-ambulance.php  
Updated: 2026-09-18

## Who pays if we crash while driving under blue lights?

Motor liability pays the other party, including on emergency runs with special road rights. Those rights do not release you from the duty of care, so ambulance services are often found partly to blame for accidents at junctions. Damage to your own vehicle is paid only by comprehensive cover, and the medical equipment on board only if it is adequately insured under that cover or an electronics policy.

## At a glance

- **Compulsory:** Motor liability for every vehicle under the Compulsory Insurance Act (Pflichtversicherungsgesetz); depending on the federal state, the licence for emergency rescue and patient transport under the state's ambulance services act requires proof of adequate liability cover
- **Biggest risk:** Accidents on emergency runs and patients falling while being carried or transferred
- **Basic cover from:** around 2,500 euros a year per ambulance or patient transport vehicle for liability and comprehensive cover
- **Statutory accident insurer:** Usually BGW (the Berufsgenossenschaft for health and welfare) for private and non-profit providers, the accident funds (Unfallkassen) for municipal services; volunteers are usually covered by statutory accident insurance
- **Often forgotten:** Medical equipment in the vehicle is usually only covered up to a limit under the own damage policy
- **WZ 2025 / NACE:** 86.92 Rettungs- und Krankentransportdienste

## What goes wrong in this trade

- **Emergency runs:** Crossing junctions on red, overtaking in traffic jams, driving at night: ambulances have a far higher accident risk than ordinary company vehicles.
- **Carrying and transferring:** A patient slips off the carry chair in a narrow stairwell or falls from the stretcher during a transfer. Fractures in older people are common and expensive.
- **Treatment on scene:** Mistakes with medication, ventilation or positioning lead to allegations against the crew. This is where the medical risk element of liability cover applies.
- **Medical equipment:** Defibrillators, ventilators and suction units are carried every day, get dropped and get wet.
- **Strain on the team:** Lifting, shift work, assaults and psychological stress lead to absences that hit the rota immediately.
- **Vehicles off the road:** An ambulance in the workshop is an ambulance that is not running. Without a replacement you lose calls and revenue.

**Risk radar** (Compared with other trades, 1 low to 5 high.): Liability 4, Fire and water 3, Theft 2, Cyber 2, Downtime 3, Health 5

## The insurance you need

- **Fleet insurance** (Essential): Motor liability is compulsory; a fleet policy with comprehensive cover, passenger accident cover and the vehicle bodywork included bundles all vehicles. https://www.nammert.com/en/insurance-broker-fleet-insurance.php
- **Business liability** (Essential): Covers harm during transport, carrying and treatment of patients, with the medical risk included. https://www.nammert.com/en/insurance-broker-business-liability.php
- **Electronic equipment** (Strongly advised): Insures defibrillators, ventilators and monitors against breakage, water and theft, also in the vehicle. https://www.nammert.com/en/insurance-broker-electronic-equipment.php
- **Business contents** (Strongly advised): Replaces furniture, stores and medicines at the ambulance station after fire, water and burglary. https://www.nammert.com/en/insurance-broker-business-contents.php
- **Group accident insurance** (Strongly advised): Adds to the statutory accident insurer's cover for the team, including in their free time, and pays for permanent injury. https://www.nammert.com/en/insurance-broker-group-accident.php
- **Business interruption** (Depends on the business): Pays for replacement vehicles and lost income if the station cannot be used after a fire. https://www.nammert.com/en/insurance-broker-business-interruption.php
- **Cyber insurance** (Depends on the business): For digital call documentation and billing with the health insurers. https://www.nammert.com/en/insurance-broker-cyber-insurance.php

## What it costs: example prices

The largest item is the vehicle fleet. On top come liability based on staff numbers and transports, medical equipment and accident cover for the team.

| Insurance | Example | Typical range |
| --- | --- | --- |
| Fleet insurance | Five patient transport vehicles and ambulances, liability and comprehensive cover | around 12,000 to 25,000 euros a year |
| Business liability | Patient transport with 15 staff, medical risk included | around 800 to 2,500 euros a year |
| Electronic equipment | Medical equipment worth 150,000 euros, also in the vehicle | around 800 to 2,000 euros a year |
| Business contents | Ambulance station with furniture and stores worth 100,000 euros | around 250 to 700 euros a year |
| Group accident insurance | 20 staff, covered around the clock | around 1,200 to 2,500 euros a year |

For comparison: Fleet and liability cover for five vehicles cost about as much a year as the health insurers pay for 150 to 300 patient transports.

_Guide prices excluding German insurance premium tax, as of September 2026, from our own quoting experience; published tariff examples for this sector are rare. No-claims history, vehicle values and area of operation change the fleet premium considerably, and we obtain the exact quote for you._

- [Finanzchef24: Versicherungen für Heilwesen und Pflege](https://www.finanzchef24.de/versicherung/heilwesen-pflegebranche)
- [Finanzchef24: Versicherung für Pflegedienste](https://www.finanzchef24.de/versicherung/pflegedienst)

## Our suggestions: three packages

- **Driving service** (Patient journeys and carry chair transport with a few vehicles): Fleet insurance, Business liability. Together: around 4,000 to 9,000 euros a year
- **Patient transport** (Qualified patient transport with a station, equipment and a team): Fleet insurance, Business liability, Electronic equipment, Business contents, Group accident insurance. Together: around 15,000 to 32,000 euros a year
- **Ambulance service** (Emergency rescue and transport from several stations): Fleet insurance, Business liability, Electronic equipment, Business contents, Group accident insurance, Business interruption, Cyber insurance. Together: from around 35,000 euros a year, calculated individually

## The worst day at the ambulance station

Six things that really happen to ambulance services, all in a single shift. Tap through the day and see who pays.

- 06:50: On an emergency run the ambulance collides with a car at a junction. Damage to the car and injured occupants. (€45,000, Paid by: Fleet insurance)
- 06:51: Your own ambulance is badly damaged; the body and the stretcher have to be replaced. (€90,000, Paid by: Fleet insurance)
- 10:30: In a narrow stairwell a patient slips off the carry chair and breaks her hip. (€40,000, Paid by: Business liability)
- 13:15: The defibrillator falls onto the tarmac in the rain and stops working. (€18,000, Paid by: Electronic equipment)
- 16:40: Lifting a heavy patient, a paramedic injures his shoulder and is off work for months. (€10,000, Paid by: Group accident insurance)
- 21:10: A cable fire in the vehicle bay damages the station, the stores and the medicines. (€65,000, Paid by: Business contents)

**Damage so far:** €268,000

## Practical tips from your broker

- Have emergency runs with special road rights explicitly confirmed in the fleet policy and check the deductible per claim.
- Insure bodywork and medical equipment at their real value; an ambulance today costs many times more than an ordinary van.
- Include the medical risk in your public liability cover so that mistakes in treatment on scene are covered.
- Arrange replacement and hire vehicles after an accident, or you will lose calls during the weeks of repair.
- Check with the licensing authority which liability sums your state's ambulance services act or your contract with the public provider requires.
- Protect your team with group accident insurance; in a tight labour market it is also an argument when hiring.

## Why NAMMERT for your business

- **We look at fleet and liability together:** As a broker we collect quotes from several insurers and align fleet, liability and equipment cover so that no claim falls between two policies.
- **We know claims handling from the inside:** In boat insurance we settle claims ourselves. We know how to document an accident under special road rights properly.
- **One contact for the business and the team:** Vehicles, the station, accident cover and staff pensions all sit with us in one place.
- **Family business since 1989:** No cost to you, as the insurer pays our commission. You reach fixed contacts, also outside office hours.

## FAQ

### Which insurance is compulsory for a patient transport service in Germany?

Motor liability for every vehicle. For the licence under the ambulance services act, many federal states also require proof of adequate liability cover for the business.

### What does insurance for an ambulance cost?

With liability and comprehensive cover usually 2,500 to 5,000 euros a year per vehicle, depending on its value, the claims history and the area of operation.

### Does liability cover pay if a patient falls while being carried?

Yes, that is a typical public liability claim. What matters is that the transport and care of patients are explicitly insured.

### Are paramedics personally covered for mistakes?

Employees are covered under their employer's public liability policy. In cases of gross negligence the employer can take recourse against them, which is why many have their own professional liability cover.

### Which statutory accident insurer is responsible?

For private and non-profit providers usually the BGW, for municipal services the regional accident fund (Unfallkasse). If in doubt, ask the insurer directly.

### Is the medical equipment covered by the vehicle's own damage policy?

Often only up to a limit. Expensive devices are better insured under a separate electronics policy that also covers drops outside the vehicle.

## Request quotes

We obtain quotes and come back with a comparison. Free of charge and without obligation: the insurer pays our commission. You can write in English. https://www.nammert.com/en/business-insurance-ambulance.php#anfrage

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NAMMERT Assekuradeur GmbH, insurance broker licensed under section 34d(1) of the German Trade Regulation Act, broker register no. D-C08Q-TOSD4-37. For boat and yacht insurance we act as underwriting agency, not as broker.

NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, +49 3375 29 12 77, info@nammert.com. Wikidata: Q141141479.