A Court Will Never Accept Legal Conclusions in a Suit
Post 5115
A Contract Cannot Legally Bind A Person Or Entity Which Is Not A Party To The Contract.
See the full video at https://lnkd.in/g3aY9Vdc and at https://lnkd.in/gnYgSbQW and at https://zalma.com/blog plus more than 5100 posts.
The plaintiff, Nataly Gasova, claimed a breach of contract related to an insurance policy which IISS sold to her. IISS moved to dismiss the complaint, arguing inter alia that there was no contract between these parties. Gasova moved to amend her complaint to abandon her breach of contract claim and instead bring claims related to the advertising and sale of the insurance policy.
In Nataly V. Gasova v. Intact Insurance Specialty Solutions, Civ. No. 1:24-CV-2279, United States District Court, M.D. Pennsylvania (June 26, 2025) Intact Insurance Specialty Solutions (“IISS”) moved the court to dismiss the suit.
Background
On November 4, 2023, Gasova was involved in an automobile accident while working as a rideshare driver. Gasova sued IISS, Uber Technologies Inc., and Farmers Insurance Exchange, alleging all three defendants were liable for a failure to make payments due to Gasova under the policy IISS sold to her, as well as alleging fraud. Gasova amended her complaint, dismissed Uber and Farmers, naming IISS as the sole defendant and alleging breach of contract.
On December 4, 2024, the parties entered into a settlement agreement wherein Gasova released all claims against IISS related to the car accident underlying this case. On December 31, 2024, IISS removed the case to federal court, claiming diversity jurisdiction pursuant to 28 U.S.C. § 1332(a). On January 7, 2025, IISS moved to dismiss the complaint for failure to state a claim arguing, inter alia, that the release foreclosed Gasova’s pursuit of her claims in the second amended complaint and that the complaint failed to state a claim as it did not establish there was a breach of contract.
DISCUSSION
Motion to Dismiss – Standard of Review
A court is not required to accept legal conclusions or a formulaic recitation of the elements of a cause of action. Threadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice. A complaint has to show an entitlement with its facts. Where the well-pleaded facts do not permit the court to infer more than the mere possibility of misconduct, the complaint has alleged-but it has not shown that the pleader is entitled to relief.
The Motion to Dismiss Will be Granted.
It is axiomatic that a contract cannot legally bind a person or entity which is not a party to the contract. Because Gasova has not alleged facts showing there was a contract between the parties, the USDC concluded she has failed to state a claim.
Gasova’s theory of liability relies primarily on IISS’s inaction, alleging that IISS failed to inform her about certain elements of the policy, which is inadequate to establish a viable cause of action.
The USDC concluded there is no contract between these parties, and that permitting Gasova’s desired amendment would be futile. Therefore, IISS’s motion to dismiss was granted and it denied Gasova’s motion to amend.
ZALMA OPINION
Some people wrongly believe that it is easy to sue an insurance company and become wealthy from the attempt. This case establishes that the belief if unfounded. Insurers fight back and refuse to pay a suit that fails to state a cause of action sufficient to allow the case to go to trial. Gasova should have stopped when she settled.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.
Posted on September 18, 2026 by Barry Zalma
See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html
In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.
The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.
Law
The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...
150 Months in Prison for Tax Fraud
Post 4846
Posted on September 17, 2026 by Barry Zalma
See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS
In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS
Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.
The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...
Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution
Post 5489
Posted on September 14, 2026 by Barry Zalma
Fraudster Refuses to Answer Questions About His Alleged Fraud
See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr
In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.
Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.
After Great American ...
Plaintiff Must Allege the Who, What, When, Where, and How requirements of Federal Rule of Civil Procedure
Post 4573
Posted on October 30, 2026 by Barry Zalma
In Texoma Cowboy Church, Inc v. Church Mutual Insurance Company, S.I., Civil Action No. 7:26-CV-00062-O, United States District Court, N.D. Texas, Wichita Falls Division (October 22, 2026) Plaintiff Texoma Cowboy Church, Inc. was insured by Defendant Church Mutual Insurance Company, S.I. under a policy covering its property at 919 U.S. Hwy 281, Wichita Falls, Texas, from May 28, 2024, to May 28, 2025. The policy carried a $309,250.50 deductible for windstorm and/or hail coverage.
FACTS
On or about April 5, 2025, a hail and windstorm allegedly damaged the property. ProNet confirmed hail impact on April 5, 2025, producing dents and panel separations on the roofing, but found that water intrusion and interior damage predated the storm. Defendant also obtained a third-party contractor bid.
After deductible and depreciation, it paid $626,607.67. Plaintiff contended the estimate and ...
Plaintiff Must Allege the Who, What, When, Where, and How requirements of Federal Rule of Civil Procedure
Post 4573
Posted on October 30, 2026 by Barry Zalma
In Texoma Cowboy Church, Inc v. Church Mutual Insurance Company, S.I., Civil Action No. 7:26-CV-00062-O, United States District Court, N.D. Texas, Wichita Falls Division (October 22, 2026) Plaintiff Texoma Cowboy Church, Inc. was insured by Defendant Church Mutual Insurance Company, S.I. under a policy covering its property at 919 U.S. Hwy 281, Wichita Falls, Texas, from May 28, 2024, to May 28, 2025. The policy carried a $309,250.50 deductible for windstorm and/or hail coverage.
FACTS
On or about April 5, 2025, a hail and windstorm allegedly damaged the property. ProNet confirmed hail impact on April 5, 2025, producing dents and panel separations on the roofing, but found that water intrusion and interior damage predated the storm. Defendant also obtained a third-party contractor bid.
After deductible and depreciation, it paid $626,607.67. Plaintiff contended the estimate and ...
Plaintiff Must Allege the Who, What, When, Where, and How requirements of Federal Rule of Civil Procedure
Post 4573
Posted on October 30, 2026 by Barry Zalma
In Texoma Cowboy Church, Inc v. Church Mutual Insurance Company, S.I., Civil Action No. 7:26-CV-00062-O, United States District Court, N.D. Texas, Wichita Falls Division (October 22, 2026) Plaintiff Texoma Cowboy Church, Inc. was insured by Defendant Church Mutual Insurance Company, S.I. under a policy covering its property from May 28, 2024, to May 28, 2025.
FACTS
On or about April 5, 2025, a hail and windstorm allegedly damaged the property.
After deductible and depreciation, it paid $626,607.67.
1. The Original Petition asserted eight causes of action:
2. anticipatory breach and breach of contract;
3. breach of the duty of good faith and fair dealing;
4. deceptive trade practices and unconscionable conduct;
violations of Texas Insurance Code Chapter 542 (Prompt Payment of Claims Act);
5. unfair insurance practices;
6. negligent misrepresentation;...
