Kinkead v. Sw. Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67 (8th Cir. 1997). · Go Syfert
Kinkead v. Sw. Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67 (8th Cir. 1997). Cases Citing This Book View Copy Cite
“enefit claimants must exhaust the review procedures mandated by before bringing claims for wrongful denial to court.”
79 citation events (69 in the last 25 years) across 11 distinct courts.
Strongest positive: Curtis Bledsoe v. Hartford Life (ca8, 1999-12-06)
Treatment trajectory · 1997 → 2026 · click a year to view as-of
1997 2011 2026
Top citers, strongest first. 25 distinct citers. How cited ↗
discussed Cited as authority (quoted) Curtis Bledsoe v. Hartford Life
8th Cir. · 1999 · quote attribution · 1 verbatim quote · confidence low
enefit claimants must exhaust the review procedures mandated by before bringing claims for wrongful denial to court.
cited Cited as authority (rule) Bey v. Board of Trustees of the Carpenters and Joiners Defined Contribution Plan
D. Minnesota · 2023 · confidence medium
Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 70 (8th Cir. 1997).
examined Cited as authority (rule) Terri Yates v. Symetra Life Insurance Company (4×) also: Cited "see"
8th Cir. · 2023 · confidence medium
In Kinkead, we held that exhaustion of administrative remedies is required even when a denial-of-benefits letter does not expressly notify a plan participant that internal review procedures must be exhausted before the participant can bring an ERISA suit. 111 F.3d at 69.
discussed Cited as authority (rule) Duncan v. Jack Henry & Associates, Inc.
W.D. Mo. · 2022 · confidence medium
In Kinkead, the Eighth Circuit explained the exhaustion requirement exists because “benefit plans are required by law to include a claim review procedure, and the duty to exhaust furthers important ERISA purposes.” 111 F.3d at 70.
discussed Cited as authority (rule) Diener v. Life Ins. Co. of North America
E.D. Mo. · 2009 · confidence medium
Submission of claim prior to filing this lawsuit Section 1133(2) of 29 U.S.C. provides that "[i]n accordance with regulations of the Secretary, every employee benefit plan shall . . . (2) afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the appropriate named fiduciary of the decision denying the claim." "Federal courts applying ERISA have uniformly concluded that benefit claimants must exhaust the review procedures mandated by 29 U.S.C. § 1133 (2) before bringing claims for wrongful denial to court." Kinkead v. Southwest…
cited Cited as authority (rule) Brown v. J.B. Hunt Transport Services, Inc.
8th Cir. · 2009 · signal: cf. · confidence medium
Cf. Kinkead, 111 F.3d at 70. 3.
cited Cited as authority (rule) Barbara Brown v. J.B. Hunt Transport Services
8th Cir. · 2009 · signal: cf. · confidence medium
Cf. Kinkead, 111 F.3d at 70. -12- 3.
discussed Cited as authority (rule) Goewert v. Hartford Life & Acc. Ins. Co.
E.D. Mo. · 2006 · confidence medium
Although, the Eighth Circuit has said that exhaustion of administrative remedies is a threshold legal question that should be reviewed de novo, Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 67 (8th Cir.1997), this Court is not deciding whether to deny Goewert's claim based on a failure to exhaust theory.
cited Cited as authority (rule) Van Natta v. Sara Lee Corp.
N.D. Iowa · 2006 · confidence medium
Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 70 (8th Cir.1997).
examined Cited as authority (rule) Theresa Wert v. Liberty Life (6×)
8th Cir. · 2006 · confidence medium
In Kinkead, however, we recognized a judicially created exhaustion requirement under ERISA by affirming a grant of summary judgment 2 On appeal, neither party cites to any Plan documents other than the certificate and Summary Plan Description, although both of these documents reference other Plan documents available for inspection. -4- against a claimant based on the claimant’s failure to exhaust contractual remedies. 111 F.3d at 70.
examined Cited as authority (rule) Theresa Wert v. Liberty Life Assurance Company of Boston, Inc. (5×)
8th Cir. · 2006 · confidence medium
We stated, “Federal courts applying ERISA have uniformly concluded that benefit claimants must exhaust the review procedures mandated by 29 U.S.C. § 1133 (2) before bringing claims for wrongful denial to court.” Kinkead, 111 F.3d at 68.
cited Cited as authority (rule) Ace Property & Casualty Insurance v. Federal Crop Insurance
8th Cir. · 2006 · confidence medium
Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 68 (8th Cir.1997).
discussed Cited as authority (rule) Ace Property And Casualty Insurance Company v. Federal Crop Insurance Corporation
8th Cir. · 2006 · confidence medium
Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 68 (8th Cir.1997). 27 A party may be excused from exhausting administrative remedies if the complaint involves a legitimate constitutional claim, if exhaustion would cause irreparable harm, if further administrative procedures would be futile, In Home Health, 272 F.3d at 560 , or if the issues to be decided are primarily legal rather than factual.
discussed Cited as authority (rule) Lacy v. Fulbright & Jaworski
5th Cir. · 2005 · confidence medium
AFFIRMED; ATTORNEYS’ FEES DENIED. 6 See Kinkead, 111 F.3d at 69 (holding that, when the appeal process is adequately described, the initial claim denial “need not be extensive” to trigger the appeal process, “provided that it explains the basis for the adverse initial decision sufficiently to permit the claimant to prepare an informed request for further review”). 7
discussed Cited as authority (rule) White, Juanita v. Aetna Life Insurance (2×) also: Cited "see, e.g."
D.C. Cir. · 2000 · confidence medium
Kinkead considered whether a notice informing the claimant that “medical evidence does not substantiate you were disabled” satisfied the insurance company’s obligation under the regulation to provide the “specific reason.” Id. at 69.
discussed Cited "see" Lisa Jones v. Aetna Life Insurance Company (2×)
8th Cir. · 2019 · signal: see · confidence high
See Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 68 (8th Cir. 1997). “[E]xhaustion of contractual remedies is required in the context of a denial of benefits action under ERISA when there is available to a claimant a contractual review procedure that is in compliance with 29 U.S.C. § 1133 and 29 C.F.R. § 2560 .503–1(f) and (g).
discussed Cited "see" Chorosevic v. MetLife Choices
8th Cir. · 2010 · signal: see · confidence high
See 29 C.F.R. § 2560.503 -l(g). 9 We have explained that “administrative efficiency is a virtue” at the initial claim denial stage, “so long as disappointed claimants are advised of their right to pursue the plan’s review procedures.” Kinkead, 111 F.3d at 69.
discussed Cited "see" Carolyn Lacy v. Fulbright & Jaworski, Limited Liability Partnership Long Term Disability Plan Unum Life Insurance Company of America
5th Cir. · 2005 · signal: see · confidence high
See Kinkead, 111 F.3d at 69 (holding that, when the appeal process is adequately described, the initial claim denial "need not be extensive” to trigger the appeal process, “provided that it explains the basis for the adverse initial decision sufficiently to permit the claimant to prepare an informed request for further review”).
cited Cited "see" Sally J. Burke v. Kodak Retirement Income Plan and Kodak Retirement Income Plan Committee
2d Cir. · 2003 · signal: see · confidence high
See Kinkead v. SW Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67 , 68 (8th Cir.1997) (“Exhaustion is a threshold legal issue we review de novo ”).
discussed Cited "see" James J. Galman v. Prudential Ins. Co. (2×)
8th Cir. · 2001 · signal: see · confidence high
See Kinkead v. Southwestern Bell Corp. Sickness & Acc. Disability Benefit Plan, 111 F.3d 67 , 68 (8th Cir. 1997).
examined Cited "see" James J. Galman v. The Prudential Insurance Company of America (4×)
8th Cir. · 2001 · signal: see · confidence high
See Kinkead v. Southwestern Bell Corp. Sickness & Acc. Disability Benefit Plan, 111 F.3d 67 , 68 (8th Cir. 1997).
discussed Cited "see" Jacqueline Stanback v. Best Diversified Products, Inc. (2×)
8th Cir. · 1999 · signal: see · confidence high
See Kinkead, v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 69 (8th Cir.1997) (concluding that appellant failed to preserve issue on appeal by not including copy of relevant pleading in the record).
discussed Cited "see" Jacqueline Stanback v. Best Diver. Products
8th Cir. · 1999 · signal: see · confidence high
See Kinkead v. Southwestern Bell Corp. Sickness & Accident Disability Benefit Plan, 111 F.3d 67, 69 (8th Cir. 1997) (concluding that appellant failed to preserve issue on appeal by not including copy of relevant pleading in the record).
cited Cited "see, e.g." Judy Dumond v. Centex Corp., a Delaware Corporation Centex Service Co., a Delaware Corporation Centex Real Estate Corporation, a Delaware Corporation Great-West Life Annuity Insurance Company, a Canadian Corporation
8th Cir. · 1999 · signal: see also · confidence medium
See 29 U.S.C. § 1133 ; 29 C.F.R. § 2560.503-1 (f); see also Kinkead v. Southwestern Bell Corp. Sickness and Accident Disability Benefit Plan, 111 F.3d 67, 68 (8th Cir.1997).
cited Cited "see, e.g." Judy DuMond v. Centex Corp.
8th Cir. · 1999 · signal: see also · confidence medium
See 29 U.S.C. § 1133 ; 29 C.F.R. § 2560.503-1 (f); see also Kinkead v. Southwestern Bell Corp. Sickness and Accident Disability Benefit Plan, 111 F.3d 67, 68 (8th Cir.1997).
Retrieving the full opinion text from the archive…
Sharon Kinkead
v.
Southwestern Bell Corporation Sickness & Accident Disability Benefit Plan Southwestern Bell Corp. Long Term Disability Plan for Salaried Employees Southwestern Bell Corporation
96-2282.
Court of Appeals for the Eighth Circuit.
May 14, 1997.
111 F.3d 67

111 F.3d 67

65 USLW 2695, 20 Employee Benefits Cas. 2704

Sharon KINKEAD, Plaintiff--Appellant,
v.
SOUTHWESTERN BELL CORPORATION SICKNESS & ACCIDENT DISABILITY
BENEFIT PLAN; Southwestern Bell Corp. Long Term Disability
Plan for Salaried Employees; Southwestern Bell Corporation,
Defendants--Appellees.

No. 96-2282.

United States Court of Appeals,
Eighth Circuit.

Submitted Dec. 9, 1996.
Decided April 9, 1997.
Rehearing and Suggestion for Rehearing En Banc Denied May 14, 1997.

Gregory G. Fenlon, St. Louis, MO, argued, for plaintiff-appellant.

David C. Welsch, St. Louis, MO, argued, for defendants-appellees.

Before FAGG and LOKEN, Circuit Judges, and KYLE,[*] District Judge.

LOKEN, Circuit Judge.

[*~67]1

Sharon Kinkead appeals the district court's[1] dismissal of her ERISA benefit claims against Southwestern Bell Corporation (Bell) and two of its employee benefits plans. Agreeing that Kinkead's suit is barred by her failure to exhaust the plans' contractual appeal procedures, we affirm.

2

Following a traffic accident, Kinkead applied for short-term disability benefits from the Bell plans in September 1989. On October 12, Bell terminated her employment. On December 18, the plans' Benefit Committee notified Kinkead of its decision that she was not entitled to further benefits. Kinkead did not ask the Committee for further review of this denial, as permitted by the plans and invited by the claim denial notice. Instead, she sued Bell for retaliatory discharge in violation of § 510 of ERISA, 29 U.S.C. § 1140. After this claim was dismissed, see Kinkead v. Southwestern Bell Tel. Co., 49 F.3d 454 (8th Cir.1995), she commenced this action to recover disability benefits allegedly due her under the plans. See 29 U.S.C. § 1132(a)(1)(B).

3

The district court granted defendants' motion to dismiss on the ground that Kinkead failed to exhaust her contractual plan remedies. Kinkead appeals, arguing that defendants' claim denial notice was inadequate and, in any event, the plans do not require exhaustion of the plan review procedures. Exhaustion is a threshold legal issue we review de novo. See, e.g., Conley v. Pitney Bowes, 34 F.3d 714 (8th Cir.1994).

4

ERISA expressly provides that every employee benefit plan must "provide adequate notice in writing" of each claim denial, and "afford a reasonable opportunity ... for a full and fair review" of each denial. 29 U.S.C. § 1133. The Department of Labor's implementing regulations contain similar requirements. See 29 C.F.R. § 2560.503-1(f) and (g). Not surprisingly, therefore, the Bell plans at issue contain provisions requiring that participants be notified of claim denials and establishing an internal procedure for further review.

5

Federal courts applying ERISA have uniformly concluded that benefit claimants must exhaust the review procedures mandated by 29 U.S.C. § 1133(2) before bringing claims for wrongful denial to court. See, e.g., Diaz v. United Agric. Employee Welfare Benefit Plan & Trust, 50 F.3d 1478 (9th Cir.1995); Communications Workers of America v. American Tel. & Tel. Co., 40 F.3d 426 (D.C.Cir.1994). Such exhaustion serves many important ERISA purposes. It "minimize[s] the number of frivolous ERISA lawsuits; promote[s] the consistent treatment of benefit claims; provide[s] a nonadversarial dispute resolution process; and decrease[s] the cost and time of claims settlement." Makar v. Health Care Corp. of the Mid-Atlantic, 872 F.2d 80, 83 (4th Cir.1989). Moreover, when a benefit plan gives the decision-maker discretionary authority to determine claims, claim denials are reviewed for abuse of discretion on the record considered by the plan decision-maker. See Ravenscraft v. Hy-Vee Employee Benefit Plan & Trust, 85 F.3d 398, 402 (8th Cir.1996).[2] In these situations, exhaustion "enhance[s] the ability of trustees to interpret plan provisions [and] help[s] assemble a factual record which will assist a court in reviewing" claim denials. Conley, 34 F.3d at 718.

6

With these basic principles established, we turn to Kinkead's specific contentions on appeal.

7

1. The denial notice. Kinkead first argues that the Benefit Committee's claim denial letter failed to comply with the notice requirements set forth in the plans, 29 U.S.C. § 1133(1), and 29 C.F.R. § 2560.503-1(f). Therefore, defendants may not enforce the contractual exhaustion requirement. See Conley, 34 F.3d at 718 (exhaustion not required when claim denial notice did not advise of appeal procedure and claimant had no actual knowledge of that procedure).

8

The Committee's letter notified Kinkead that it had examined her file, "including a medical report from your doctor and the opinion of our Medical Advisor," and was denying her claim "because medical evidence does not substantiate you were disabled." The letter advised that the Committee "relied upon the provisions of Article 4, Paragraph 4.1 of the Plan" and went on to quote that provision. Regarding review procedures, the letter stated:

9

You have the right to request that your claim denial be reviewed and to review pertinent documents relating to the denial. If you wish your denial of claim for benefits to be reviewed, you or your authorized agent may submit a written request for review to [the Benefit Committee's Secretary]. A request for review must be submitted within sixty (60) days of your receipt of this letter. It is important that any additional information you would like to be considered at the time of review accompany your written request.

[*~68]10

The Committee's letter adequately described the claim review process. It advised Kinkead she had a right to further review and to examine the Committee's file. It told her where and when to submit a request for review and whether she could submit additional information. Thus, this case is distinguishable from Conley, where the claim denial notice made no mention of an appeal process. Kinkead argues that she was entitled to a clear statement that she must exhaust this review procedure. But neither the statute, the Department's regulations, nor any prior case imposes such a notice requirement. Given the practical reasons favoring exhaustion, claimants with notice of an available review procedure should know that they must take advantage of that procedure if they wish to bring wrongful benefit denial claims to court.

11

Kinkead further argues that the Committee's denial letter failed to provide a sufficiently detailed analysis of the reasons for denying her claim, as we required in Brumm v. Bert Bell NFL Retirement Plan, 995 F.2d 1433, 1436-37 (8th Cir.1993); Cox v. Mid-America Dairymen, Inc., 965 F.2d 569, 573-74 (8th Cir.1992); and Richardson v. Central States, S.E. & S.W. Areas Pension Fund, 645 F.2d 660, 665 (8th Cir.1981). But in these cases, we were reviewing, on the merits, final claim denial letters that did not provide an adequate explanation of the plan administrator's discretionary decision. See Collins v. Central States, S.E. & S.W. Areas Health & Welfare Fund, 18 F.3d 556, 561 (8th Cir.1994) (final denial notice adequate if it "permit[§ claimant] to challenge the denial in federal court and for us to review it"). Here, on the other hand, we deal with an initial claim denial notice. At this early stage of the claim process, administrative efficiency is a virtue, so long as disappointed claimants are advised of their right to pursue the plan's review procedures. Therefore, the initial claim denial need not be extensive, provided that it explains the basis for the adverse initial decision sufficiently to permit the claimant to prepare an informed request for further review.

12

In this case, the Committee's letter notified Kinkead that her claim was denied "because medical evidence does not substantiate you were disabled." The letter told her what medical reports the Committee had considered and advised her that she could review these documents and submit additional information with her request for further review. The letter was sufficient to trigger an appeal process that Kinkead was required to exhaust.

13

2. The Plans' Exhaustion Requirement. Kinkead next argues that the Bell plans create an optional review procedure, not a procedure that claimants must exhaust. The district court's opinion expressly states that Kinkead did not raise this issue in opposing defendants' motion to dismiss. In her reply brief to this court, Kinkead asserts that the district court overlooked her "response to defendants' reply in support of motion to dismiss," a pleading she did not include in the record on appeal. We conclude that this issue is not properly preserved.

14

In addition, while we agree that the need to exhaust is a question of contract interpretation, see Schneider Moving & Storage Co. v. Robbins, 466 U.S. 364, 104 S.Ct. 1844, 80 L.Ed.2d 366 (1984), benefit plans are required by law to include a claim review procedure, and the duty to exhaust furthers important ERISA purposes. In these circumstances, any plan claim review procedure that meets the requirements of 29 U.S.C. § 1133 and 29 C.F.R. § 2560.503-1(f) and (g) will trigger the judicially imposed duty to exhaust that remedy.[3]

15

The judgment of the district court is affirmed. Appellees' motion for costs and attorney's fees is denied.

16

KYLE, District Judge, dissenting.

17

I respectfully dissent from the majority's conclusion that the plans were not required to advise Kinkead that, after being notified that her application for benefits had been denied, she must exhaust their appeal procedures before filing suit in federal court.[4]

18

The Court writes that "neither the statute, the Department's regulations, nor any prior case imposes such a notice requirement." ERISA itself, however, does not contain any exhaustion requirement. The statute is silent on this issue; exhaustion is a judicially created requirement. See Conley v. Pitney Bowes, 34 F.3d 714, 716 (8th Cir.1994).

19

The opinion states that: "[G]iven the practical reasons favoring exhaustion, claimants with notice of an available review procedure should know that they must take advantage of that procedure if they wish to bring wrongful benefit denial claims to court." (Emphasis added). While there are practical reasons favoring exhaustion, it does not, in my view, follow that claimants should know that they must take advantage of those procedures if they wish to file a lawsuit to enforce their benefits. We are not necessarily dealing with sophisticated employees or lawyers specializing in ERISA claims. Requiring the plan to clearly advise a claimant of the consequences of not exhausting the administrative review process would not place a substantial burden on the plan administrators, but it would explain the adverse consequences to an uninformed claimant.

[*~69]20

In summary, I believe that a plan should be required to clearly inform a claimant that its internal review procedures must be exhausted before, and as a condition of, seeking judicial relief. The plans under review here failed to so inform Kinkead. Accordingly, I would reverse the Order of the District Court and allow Kinkead to proceed with her ERISA benefit claims against Bell and its two plans.

*

The HONORABLE RICHARD H. KYLE, United States District Judge for the District of Minnesota, sitting by designation

1

The HONORABLE CAROL E. JACKSON, United States District Judge for the Eastern District of Missouri

2

The Bell plans grant such discretionary authority to the Benefit Committee

3

Kinkead relies on Conley for the proposition that benefit plans must explicitly require exhaustion. But the contractual duty to exhaust was conceded in Conley; we considered only whether that duty should be imposed on a claimant who had no notice or knowledge of the plan's claim review procedure

4

I concur with the majority's conclusions that the Committee's claim denial letter adequately described the claim review process and provided a sufficiently detailed analysis of the reasons for denying Kinkead's claim