In the latest slapdown of insurance shenanigans, the Western District of Pennsylvania dropped a detailed, point-by-point takedown of Unum’s denial of long-term disability (LTD) benefits in Mundrati v. Unum Life Ins. Co. of Am., 2025 U.S. Dist. LEXIS 53449

Let’s dig into why Unum lost — and lost hard.

Background: Dr. Pooja Mundrati and a 3-Year Medical Odyssey

Dr. Pooja Mundrati, a highly specialized interventional spine physiatrist, suffered serious injuries from a 2018 car accident. Her symptoms ranged from persistent migraines and fatigue to cervical spinal stenosis requiring surgery. For years, she pushed through part-time work with documented restrictions from treating physicians — all while Unum sat on the sidelines.

In 2021, her employer terminated her after refusing to accommodate her medical limitations. She applied for LTD benefits under her ERISA-governed policy with Unum — and was denied. Twice.

Unum’s Arguments (and Why They Didn’t Hold Water)

Unum claimed Dr. Mundrati wasn’t disabled.  Here’s how the court dismantled that position:

  1. Misclassifying Her Occupation

Unum labeled her job as “physician” with light duty, when in reality, she was an interventional spine physiatrist — a medium-duty job per the Dictionary of Occupational Titles. The court called Unum out for ignoring her actual specialty, which the plan explicitly required them to consider. This isn’t a minor semantic issue — it directly impacted how her physical and cognitive limitations should have been evaluated.

  1. Cherry-Picked Medical Reviews

Unum leaned on file reviews by its own hired guns, none of whom examined Dr. Mundrati. One doctor even dismissed her fatigue because it lacked a “converging organic diagnosis.” Translation: No test, no disability. Never mind that fatigue, migraines, and vision issues can’t always be confirmed by lab results. Courts have repeatedly said you can’t just ignore subjective symptoms — especially in cases involving brain injuries and chronic conditions for which there is no objective diagnostic test.

  1. Ghosting the Treating Docs

Unum’s medical reviewers either dismissed or flat-out ignored the conclusions of treating physicians — the people who actually examined Dr. Mundrati over years. Even when Dr. Mundrati submitted Unum’s questionnaire filled out by her neurosurgeon (who said she was unequivocally unable to perform her job), Unum discounted it without explanation.

  1. No IME, Just Opinions from Behind a Desk

Unum never ordered an independent medical exam — despite being allowed to under the policy. Instead, it relied solely on paper reviews, one of which twisted “limited participation” in a Functional Capacity Test into a knock against Dr. Mundrati. The reality? She couldn’t finish the test because she became visibly fatigued — exactly the point of the test.

The Court’s Verdict: Arbitrary, Capricious, and Completely Unsupported

Judge Patricia Dodge called it like it was: Unum’s denial was riddled with flawed reasoning, mischaracterization of evidence, and procedural shortcuts. The court didn’t just find Unum wrong — it found Unum’s entire approach fundamentally unfair.

Unum’s motion for summary judgment was denied and
Dr. Mundrati’s motion was granted.

Takeaways for Claimants and ERISA Practitioners

  • Don’t let insurers redefine the occupation. Push back hard when they apply a generic job label that doesn’t reflect your client’s actual role.
  • Call out cherry-picking and biased paper reviews. Courts are increasingly skeptical of insurers who selectively quote the record or rely exclusively on non-examining consultants.
  • Keep pressing for a fair process. If an insurer won’t do an IME and refuses to credit treating doctors, that’s often a red flag the court will take seriously.