This is the experience I had before during and after my slip and fall with the Melting Pot and their insurance company Erie Insurance.
How are you going to deny a claim based on what YOU feel someone is familiar with? How can you talk for me...and tell me what I'm familiar with? As you will see everything is blamed on me the customer and clearly the restaurant has no duty of care to the customer. First Erie Insurance wanted to tell me that there wasn't anything on the stairs that made me fall and they stated it was my word against theirs and then once Erie Insurance called me to tell me the claim was denied I brought it to the adjusters attention that the manager at The Melting Pot agreed that there was something on the stairs, Erie Insurance then decided to CHANGE their denial reason and is now saying it was my fault because I should have seen what was on the stairs. Really? Even though the hostess stand is right in front of the stairs so I should have seen what was on the stairs but the hostess who stands there all day didn't have to see it? So in other words even though I walk down the stairs holding on to the rails following all safety precautions while walking down the stairs, I'm not jumping around like a lunatic on the stairs or skipping stairs I'm walking down the stairs holding on to the rail I slip and fall on paper/liquid and somehow its still my fault. So apparently the restaurant does not owe their customers a duty of care?
As you will see Erie Insurance has a serious problem I have been discriminated against because according to Erie Insurance I've been in the restaurant before so in other words if I'd never gone to that restaurant my claim would have been approved because I wouldn't have been familiar with the layout of the restaurant? What kind of mess is that? Are you serious? This is an Insurance Company and this is a reason for them to deny a claim and this is fair and legal? This is within compliance? Really? How many other Black, Woman or and Third Party Claims have they treated like this?
I was in the restaurant,The Melting Pot, on the 24th of May 2021. As I proceeded to walk down the stairs towards the host, I slipped and fell. The hostess proceeded to do absolutely nothing but watch it happen. It wasn't until after my fall that I noticed the paper and liquid spilled on the steps. The hostess didn't even have the decency to try and help me! I got up by myself, gave her the paper that was on the stairs, and advised her there was liquid on the stairs as well. She looked at me, said "Okay.", and then proceeded to take a phone call. She then put the phone down and left to go into a room. After a few minutes, she came back and told the caller that she spoke to her manager, and confirmed that they did not have any promotions for that day. She then hung up the phone and asked me if I had a reservation. All I could think of was, "Are you serious?"
I then had to request for a manager to come and talk to me regarding the fact that I just slipped on paper and liquid, which made me fall down their stairs. The manager, Monica, then came out and I proceeded to tell her who I was and what happened. In addition to that, I showed her the paper that I slipped on and gave to the hostess, while I also pointed out the liquid that was on the stairs. The manager then looked at me and mentioned, "We have the same name, Monica." Now I'm thinking to myself, "What the hell is wrong with these people? The hostess, Autumn, is in la la land, and the manager is not far from it." The manager then stated she was sorry that they didn’t get the liquid and paper off the stairs ahead of time, and for there not being any carpet on the stairs as well, to which I agreed. I then proceeded to tell the manager, Monica, about the hostess and how she did absolutely nothing regarding me falling down the stairs. She told me she was sorry about that and would take me to my seat.
Once I got to my table, Manager Monica apologized, again, regarding the hostess. She told me the hostess was new, however, she's very standoffish and shy. I'm now thinking, ‘But you hired her to be your host?’ She then added, “But she's very nice.” I advised the manager, “The hostess can be nice all day long and that's great. However, it's a liability to have one of your employees stand there and watch a customer falling down the stairs and do absolutely nothing. And to make matters worse, a hostess who then feels it's more important to take a phone call from a potential customer and seek out a manager regarding a promotion that doesn’t even exist, rather than, getting a manager to assist a customer that's currently in your restaurant and that has fallen down the stairs in front of your face, that has nothing to do with being nice, shy, or standoffish. That's what you call an expensive liability and not using common sense. And perhaps if I would have immediately gotten assistance from the employees, I may not be in all the pain that I'm currently in right now!” Once again, Manager Monica agreed and reiterated that she understood and they will make sure they get the stairs cleaned. She then asked if I was hurt, and I told her I was very sore, but I hoped to be okay. She said okay, indicated she would have a really good server to come and help me, and then walked away.
Not once did she suggest taking a report, even though I just fell down the stairs in her restaurant due to The Melting Pot’s negligence! Once the server came, I had to request for an incident report to be completed. The server said okay and went and got another manager for me. The new manager, Jason, came to the table and I told him that an incident report needed to be filled out, and that the previous manager, Monica, NEVER took a report or even suggested anything like an incident report to be completed! Manager Jason told me he's only ever had to complete an incident report once, so they didn't have proper incident report documents to give me, and he would write down what happened on a piece of paper. He then told me he would email me a copy of the report, and advised me to check my junk file because his email address is not common. He also stated that he doesn’t type fast, so if I didn't receive the emailed report that day then I should receive it the next day. I was then provided the option of taking an elevator, hidden from the public, for staff use only, when I was done, which I accepted. Once I was finished with my food, I paid for my check, which, considering the situation, I shouldn’t have had to do, and used the hidden elevator to leave.
To this day, I have not received any emails regarding the report, nor have I gotten any phone calls asking if I'm okay. The next morning, I went to the ER due to the pain that I was having and had to endure numerous uncomfortable x-rays, as well as being prescribed medication and having to take time off of work. I am now seeing an Orthopedic Surgeon and going to Physical Therapy for nerve damage to my dominant right hand. As you can see, I have a serious issue with this restaurant and its employees. There are a lot of things that didn’t go the way they should have gone, starting with the hazardous stairs, the hostess, Autumn, and the manager, Monica. The lack of immediate concern is ridiculous and something needs to be done! In no way was this my fault. I was a customer coming to your restaurant to have a nice meal, (I dididn't even stay for a meal I had dessert and left) and this is what happened. In addition, I did reach out to the corporate office and was advised that this is a franchise. However, I was also advised that someone would be in contact with me from corporate to look into this situation as well. That never happened!
Rebecca with Erie Insurance called me to obtain a recorded statement.
I received another call from Rebecca, stating she spoke with the manager and hostess with The Melting Pot, as well as saw the pictures that her investigator went out and took for her. She then stated it was decided that they're only going to pay my medical bills, but not compensate me for pain and suffering. She then went on to say they are not accepting liability and the claim is denied because it's “my word against theirs” and there was NOTHING on the stairs. For clarity, I reiterated to Rebecca, “My claim is denied and liability is not being accepted because you guys are saying there was nothing on the stairs, correct?” She told me YES! I then told Rebecca that was not true and stated that I gave the paper to the hostess, as well as pointed out the liquid on the stairs to her. I even told Rebecca that the information is in the report the manager, Jason, took from me which should be in his statement. Plus the other manager, Monica, came out to the host station, saw the paper and liquid, and said she was sorry and will get it taken care of. She also indicated, at that time, that there should be carpet on the stairs because she knows those steps are really hard. I said to Rebecca, “I don't understand why my claim is being denied, and liability is not being accepted due to nothing being on the stairs because that's just not true!” Rebecca then said, “Just a moment. Let me look back through the notes/statements from the manager at the Melting Pot.” (This is NOT new information. Looking through the statements should have been done prior to a claim being denied. The adjuster has a DUTY to look at ALL facts first this is apart of the claim investigation. Clearly this demonstrates Erie Insurance is not working within Compliance and their NOT following the state rules and regulations for investigating/handling an insurance claim) She then came back and said, “Okay, the manager DID say that there was paper on the stairs, and yes you did give the paper to the hostess, so that is true. However, it's still your responsibility to look where you're going and when you're walking down the stairs.”
I asked Rebecca, “So how are you denying the claim based on nothing being on the stairs, when the statement you just read from the manager confirms what I have been saying? You just admitted to me that the manager confirmed there was paper on the stairs and it was given to the hostess!” I continued to tell Rebecca, “It is your job and duty as a licensed adjuster to perform a complete and detailed investigation before denying a claim, and clearly that was NEVER done.” In addition, I told her she was doing something untrustworthy and she is NOT being fair and honest! I said to her, “You can't just pick reasons out of a hat to back up your denial, and the sad part is, what you're denying my claim for is not even true or accurate!” I then requested her manager's Information and she went on to tell me, “That's fine, however, it was still my responsibility when I'm walking down the stairs.” Even though the lights inside The Melting Pot are dim it was still, somehow, my responsibility regardless to whatever is on the stairs.
I then asked if her lines were being recorded, and she said, “No, this isn’t Nationwide or State Farms.” Once she provided her manager's information I told her I wanted a letter mailed and emailed to me, showing that my claim was denied and the reason it was denied. I also requested a copy of the incident report that the manager took from me the night of the accident. I told her that he said he would send me a copy via email weeks ago, but I never received it, and she told me that she's not able to provide that incident report to me either!
I later called and spoke with her manager, Raymond Rose, and he stated he was aware of this situation and claim, and was aware that the claim was being denied. I then went on and explained to him what had just happened with Rebecca, in great detail, regarding her and the handling of my claim. He then went on to tell me that he's worked with Rebecca for many, many years and has never had any issues or complaints against her. I simply stated, “First time for everything!” I recounted to Raymond that, “I was told my claim was denied because it was my word against theirs, and there wasn't anything on the stairs which caused my fall. However, after I brought that point up to Rebecca, she then went back through the notes and statements from the manager, and AGREED that there was paper on the stairs and it was given to the hostess, but now she's saying it was my responsibility because I was walking down the stairs.” Raymond then asked me if I had ever had an accident before. He said, according to my Recorded Statement, I never had an accident, and I told Raymond, “First, I don't know what that has to do with what I was just telling you regarding Rebecca, and how she denied my claim without reviewing ALL of the facts FIRST. However, I did not say I never had an accident, I said yes I had an accident, but at the time I had no injuries.” He then said, “Well, I'm just telling you what we have here, and in her report, she has it where you said you never had an accident.” I, of course, told him, “This is ridiculous! You're not even addressing the issue that I have regarding your adjuster who denied a claim without reviewing all the facts first!” I then advised him to, “Go and listen to the recorded statement, and call me back to let me know what you hear, since this is more important than your adjuster not properly handling a claim, and denying a claim on false information and switching denial reasons in mid-sentence to support her denying a claim.” I admitted, “I have absolutely nothing to hide, and clearly, if you're telling me in the report that Rebecca put together, it indicates that I never had an accident, then that's a lie because my recorded statement clearly indicates, yes I had an accident, but no I had no injuries. Which was many years ago!” He said, “Fine, I will.” and hung up on me.
Hours later, I received a call back from Raymond stating they will be covering my medical costs up to $10,000. He confirmed my address and also stated he knows Rebecca indicated she wouldn't send me my incident report, however, he will do me a favor and mail it to me. He then asked if there was anything else I needed and I told him, “Yes. Initially, you wanted to challenge my recorded statement and that was the reason for you calling me back. So what did I say in my statement that warrants all of this, and what also warrants you ignoring the fact that your adjuster denied a claim without properly investigating the claim, and denying the claim on false information?” He then went on to say that in my statement I hesitated and said no, I didn't have any injuries, but yes I was in an accident. I confirmed for him, “That's correct, the accident was a long time ago, so what the heck is the problem? Why am I being treated this way?” He told me, “LOOK, we approve or deny claims based on the merits of the case. We're not saying you didn't fall, we're saying it's not our fault.” I asked him, “If that’s so, why are you questioning my recorded statement? Why aren't you concerned that you have an adjuster that is denying claims not based on the facts, and not reviewing all the facts and making a decision, but making a decision first and then switching up the facts to support her denial?” He then indicated, “I questioned you about your recorded statement because I wanted to know.” I asked Raymond, “So what is the claim actually being denied for? What is the actual reason?” and Raymond hesitated.
Then he said, “Because we don't agree with how you fell. There was nothing on the stairs and the facts do not support what you're saying. We know you fell, but we don't feel it's our fault.” I asked, “Oh, so you're saying the Melting Pot is indicating there was nothing on the stairs, right?” and Raymond yelled at me and said, “Don't put words in my mouth!” I told Raymond, “I am an Independent, Educated, Black Woman. Don't you EVER disrespect me by yelling at me, or talking to me like I am a dog, or less than, or by trying to insult my intelligence!!!” he then began to laugh, I then added, “You're the manager! It's your job to try and deescalate a situation, or to figure out and investigate the complaint as well as addressing my concerns, not to make the situation worse!!! I'm not putting any words in your mouth, I'm simply trying to understand and get a clear and concise answer from you, the manager in the liability claims department, who is over the adjuster, Rebecca, for the reason why my claim is denied.” He then told me, “LOOK! I don't know what the manager at The Melting Pot said because I wasn't there!” I snapped and told him, “You don't have to be there to properly investigate a claim, to look at all of the notes, facts, and statements in the file (not just my statement). But then you want to tell me about you not being there when I'm questioning you regarding your policyholder's statement, the lack of investigation, and the inconsistencies between what you're saying and what the adjuster is saying, regarding my fall and the reason for my fall! This is supposed to be the REASON my claim was denied but instead of being professional and someone working within the insurance industry as well as being someone who manages over licensed adjusters and who should be holding them accountable for their claim file and enforcing that they are complying with all of the rules and regulations, you tell me you weren't there, and I'm supposed to be okay with that comment and answer? That's how Erie Insurance handles liability third party claims? They don't care about compliance? Erie Insurance feels that's what I deserve? Is that how Erie Insurance treats Blacks and or Women? You disrespect me by yelling at me on the phone, you try and talk to me like I'm a dog, or I'm under you, or I'm less than! You could care less about me and how your adjuster did not properly investigate a claim and denied the claim on false information!” After all of that Raymond then told me to go and talk to one of my colleagues because I don't know what i'm talking about he then added, I was just mad because my claim was denied and because they’re not paying me for pain and suffering. I told Raymond, “You’re playing games and I'm done! I don't appreciate the evasive answers, the disrespect and the lack of being clear and concise when it comes down to why my claim and the reason for it being denied.” In addition, I advised him that his answers and denial reasons didn't match up with what his adjuster stated!
If this was your claim, would you be okay with the way you were treated the way you're claim was handled and the different reasons you were told it was denied? Would you EVER go back to the Melting Pot?
What if this was your experience in your claim and how you were treated how would you feel? Philmin LLC, Leo Carl, Dan Hawkins
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