By Marc Snyder, Esq. and Chris Harris, Esq.
Litigation under ERISA is not for the faint of heart. When we took on Mundrati v. Unum, we knew the road would be long. The standard of review—arbitrary and capricious—is among the most difficult in our civil justice system. Courts must defer to the insurer’s decision unless it is completely unsupported by the record. It’s a legal tightrope—one where even a small misstep can be fatal. But we believed in Dr. Pooja Mundrati’s case, and we fought tirelessly to prove it.
This wasn’t just about long-term disability benefits. It was about fairness, and restoring dignity to a dedicated interventional spine physician whose life was upended by a car accident.
The Work Behind the Win
This case consumed months of intensive effort. We combed through over 2,600 pages of administrative records—reviewing medical reports, objective and vocational assessments, functional capacity evaluations, and personal statements. We presented oral arguments and prepared multiple rounds of briefing to ensure the judge had a complete and accurate picture.
Every detail mattered. Every inconsistency in Unum’s rationale, every sidestepped symptom, every flawed vocational classification—it all had to be exposed. The level of medical complexity required us to master not only ERISA law but also the physical demands and nuances of interventional spine procedures.
Fighting the “Arbitrary and Capricious” Standard
ERISA litigators know the phrase well, but its real-world application is daunting. It’s not enough to prove that the insurer was wrong—you must show they were irrationally wrong. That their decision wasn’t just incorrect, but made in a way that defied logic or ignored overwhelming evidence.
In Mundrati, Unum denied benefits despite extensive objective and clinical evidence. The insurer repeatedly claimed her occupation was “light duty”—even though her specialty clearly met the Department of Labor’s definition of “medium duty” work. Under their own policy, Unum was required to consider her actual duties, not just a generic job title.
We challenged this misclassification directly. Dr. Mundrati’s work involved complex, physically demanding procedures—such as inserting needles into patients’ spines. Her role couldn’t be lumped into a generic “physician” category. It was a specialty requiring peak physical and cognitive function. The judge saw it exactly the same way.
The Judge Agreed—On Every Issue
Magistrate Judge Patricia Dodge issued a detailed, thoughtful opinion granting our motion for summary judgment and denying Unum’s. She found that Unum’s decision was indeed arbitrary and capricious. She agreed with us on every major point:
- Occupation Misclassification: Unum ignored the physically demanding nature of Dr. Mundrati’s interventional spine practice.
- Disregard of Evidence: The insurer dismissed critical evaluations as “not time relevant”—a position the court found unreasonable given consistent support across the record.
- Selective Medical Review: Unum focused only on records supporting its denial, rather than evaluating the full medical picture.
- Improper Consultant Reliance: The decision leaned on non-examining, non-specialist consultants over Dr. Mundrati’s treating physicians.
A Cautionary Tale—and a Call to Action
This case highlights how difficult it is for even highly qualified professionals to receive fair treatment under group disability policies. Dr. Mundrati wasn’t just any claimant—she was a respected interventional spine specialist whose career was derailed by injuries outside her control. Yet her insurer denied benefits, ignored substantial evidence, and minimized the complexity of her work.
To fellow attorneys handling ERISA cases: keep fighting. The arbitrary and capricious standard may be steep—but it is not insurmountable. Detail wins. Consistency wins. Truth wins.
And to professionals and claimants struggling through long-term disability claims: don’t give up. There are paths to justice. Dr. Mundrati’s case shows that with the right legal team and a judge willing to closely examine the record, victory is possible.
We’re proud to have helped Dr. Mundrati take the first step toward justice—and grateful that the court recognized this case for what it was: a denial not just of benefits, but of basic fairness.