NEWPORT BEACH, Calif., Jan. 24, 2024 /PRNewswire/ — McKennon Law Group PC, a national law firm specializing in representing claimants and employees in bad faith insurance and ERISA benefits cases, is proud to announce a significant victory for disability benefits claimants.

The case, Kayle Flores v. Life Insurance Company of North America, No. 22-55779, 2024 WL 222265 (9th Cir. Jan. 22, 2024), involved a claimant who had short-term disability (“STD”) and long-term disability (“LTD”) coverage through her employer.  She was denied STD benefits and brought suit in federal court.  The claimant also sought LTD benefits, even though she had never submitted an LTD claim.  The district court agreed that the insurance company incorrectly denied STD benefits but also held that the claimant was not entitled to LTD benefits because she did not file an LTD claim.

The claimant then filed an LTD claim with the insurer which was also denied.  She brought a second lawsuit and the insurer moved to dismiss the case on the grounds that the question of eligibility for LTD benefits was already decided and could not be relitigated.  The district court agreed and dismissed the case because of the res judicata/claim preclusion doctrine.

The claimant appealed and the Ninth Circuit reversed the dismissal.  The Court concluded that the claimant’s cause of action for LTD benefits did not accrue until she submitted an LTD claim and received the denial from the insurance company.  Since the LTD denial came after her first lawsuit, the question of eligibility for LTD benefits could not have been litigated in the first case.

“We are very pleased with the Ninth Circuit’s decision in this case,” said Robert McKennon, founding shareholder of McKennon Law Group PC and attorney for the plaintiff.  “The decision was correct from both an equitable and legal perspective.  Our client will now be able to pursue the LTD benefits that she desperately needs, and we look forward to continuing our fight against the insurance company.”   

This decision is significant because the issue of res judicata/claim preclusion in this situation had never been addressed in the history of U.S. jurisprudence and substantially protects employee benefits to ensure technical legal doctrines do not deprive them of their much needed employee benefits.

Attorneys Robert McKennan and Joseph Hoff represent the plaintiff, Kayle Flores.

McKennon Law Group has over 70 years of experience specializing in long-term disability and short-term disability insurance, life insurance, health insurance, accidental death insurance, and long-term care claims, as well as all types of ERISA litigation claims involving employee benefits, including group insurance claims, pension claims and severance claims.