Insurance justice sought for fallen volunteers

By Joseph Picard
Sussex County — Bill Martin, 56, was a volunteer for 23 years with Stillwater Emergency Rescue. On Jan. 8, 2013, Martin and other volunteers responded to a house fire where one resident died and the other was severely burned. Martin drove the ambulance carrying the critical survivor to a Medevac landing, whence he was to be helicoptered to a hospital burn unit. En route to the landing, Martin suffered a heart attack. The burn victim made it to the hospital, but Martin did not survive.
Three years later, on January 16, 2016, Scott Danielson, 49, a 35-year volunteer at the Lakeland Emergency Squad, responded to a car accident on Route 206 in Byram. He learned, while on the way, that one of the victims was his daughter, Alycia. He treated his daughter at the scene and followed the ambulance to the hospital, where he collapsed. Despite emergency care for cardiac arrest, Danielson died without regaining consciousness.
Both volunteers were insured through their townships and their surviving families were eligible to apply for death benefits under the state’s Workers’ Compensation Law. Yet neither family has seen a penny of the death benefit. It’s been a year and a half for the Danielsons, and four and a half years for the Martins.
“It’s crazy,” Scott Danielson’s widow, Tammy Danielson, said. “Tt’s like the insurance drags it out as long as possible, thinking you’ll get frustrated and settle for some inadequate amount.”
Tammy Danielson has rejected at least one settlement offer from the insurer, Statewide Insurance Fund. She said the offer, for the rest of her life, amounted to less than her husband made in a year.
Teri Martin, Bill Martin’s widow, said she has received no settlement offers from the Stillwater Township carrier, Selective Insurance, but has been frustrated by seemingly endless delays in processing her claim.
“One of the things they do is ask for information that I have already given,” Martin said.
She said the insurer recently requested Bill Martin’s employment records. She told her attorney that the insurer had been given those records as early as three months after her husband’s death.
“My lawyer said we have to play the game. It seems all the insurance company does is play games,” Teri Martin said.
Both insurers involved were contacted for comment. Selective Insurance responded with a statement:
“We have great sympathy for Bill Martin’s family given his unfortunate death while on duty with the Stillwater Emergency Rescue Squad. Selective has paid benefits under the governing policy and is working to resolve the claim that the Martin family’s lawyer filed a year and a half after Mr. Martin’s death.”
Teri Martin said that, although she submitted documents regarding her husband's insurance to Stillwater Township, she was never notified by the township or the insurer that she and her family were eligible for the death benefit.
"I only found that out about six months after Bill's passing, from a friend who happened to be a lawyer," she said.
“I’ve been in the insurance business for over 30 years,” said Sussex County Freeholder Director Carl Lazzaro. “I know insurance companies can be vicious. They are quick to jump on possible fraud, but drag their feet when it comes to paying out claims.”
Lazzaro heads an insurance office in Newton. He is also a long-time volunteer and was at the scene in Stillwater in 2013, speaking with Bill Martin shortly before his heart attack.
“These men, both Bill and Scott, were volunteers,” Lazzaro said. “They gave up their time to do this. They gave up their families to do this. Then they die in the line of duty and their widows and families are denied the death benefit. It’s unconscionable! The money is there. Municipalities pay thousands of dollars to cover the volunteers, and these men were certainly covered. And the number one cause of death among EMTS is a cardiac event. The insurance companies know this. There is no question these men qualified for the death benefit. This situation is so wrong. It has to be fixed.”
The Martin and Danielson families may not be getting what they want from the insurance companies, but they are now getting some extra help. A group of family members, friends and first responder volunteers have come together to form the Committee for Justice for Bill and Scott. The group, which has the support of Lazzaro, has an ambitious agenda to raise awareness of the dire situation facing not only the Martin and Danielson families, but other families of deceased or injured volunteers throughout the county and the state who are hampered in collecting insurance benefits.
According to a statement released by the group last week, they will be reaching out to volunteer organizations throughout the state soliciting their active support. They will also be informing the public and asking citizens to join in the effort by pressing local and state officials to stand up for volunteers and their families.
“We also want this deplorable situation investigated,” said Eskil “Skip” Danielson, the father of Scott Danielson. A former Byram police chief and township mayor, the elder Danielson is spearheading the effort to make things right for the surviving families.
The committee is calling on high-ranking state officials, including the Commissioner of Labor and Workforce Development, the Commissioner of Banking and Insurance and the Attorney General, to examine insurance industry practices, especially intentional acts or patterns of procrastination and differential treatment.
“If these volunteers had a strong union like the police do, the insurance companies would not have dared to delay benefits,” Danielson said.
Teri Martin echoed the sentiment.
“When a police officer dies, there is an advocate from the police union knocking on the widow’s door that same day, letting her know what to expect, what she deserves and how to go about getting it,” Martin said. “And letting her know that they will be there to help her. I got none of that. No advocate knocked on my door. And no one, not the insurer, not the township, even told me I was eligible for a death benefit."
The Committee for Justice for Bill and Scott is also enlisting state legislators to modify the state’s Workers’ Compensation Law.
According to the New Jersey Workers’ Compensation Law (34:15-7.3), there is a “presumption of compensability,” for cardiovascular or cerebrovascular injury or death of “police, fire or emergency personnel in response to emergency,” with emergency further defined as “any combination of circumstances requiring immediate action to prevent the loss of human life.”
The law also calls this presumption of compensability “rebuttable,” meaning an insurer can reasonably dispute a claim. The law also has no time limit for how long an insurer can take to process a claim. It is this lack of a time limit that the committee wants legislators to change.
“We want a limit of six months from the time of notification for the insurance company to make a determination,” Skip Danielson said.
“Six months is a very reasonable time period,” Lazzaro said. “Insurance companies typically wind up the business of a claim before six months.”
Assemblyman Parker Space (R-Sussex) has been contacted by the group and is onboard with trying to amend the law.
“I’ve been a first responder myself for over 20 years,” Space said. “I know the family’s expectation if something bad happens, and I’ve seen what has happened. I’ve told the group that I will do whatever I can to get this law modified.”
Space said he is already talking with staff and colleagues about preparing legislation.
“We’ve been waiting 18 months, and it’s been incredibly tough and frustrating,” Tammy Danielson said of her family’s ordeal. “And Teri Martin’s been waiting close to five years! I can hardly imagine what she has gone through.”
“I do not want anyone else to have to go through what my family has experienced,” Martin said.
Skip Danielson was determined.
“I was at my son’s side when he was pronounced,” he said, his voice husky with tears. “I closed his eyes. And I promised him that his wife and family would be taken care of. And I’m going to keep that promise.”