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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GoFundMe Request Based on Fake Claim of Racial Animus
Post 5199
Posted on October 2, 2025 by Barry Zalma
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An Attempt to Profit the Public by Setting Fire to his Own Food Truck Fails
Avonte Ahikim Hartsfield burned down his own food truck and falsely reported that he was the victim of arson in October 2021. He then created a GoFundMe campaign titled “Rebuilding After a Series of Hate Crimes,” claiming he was a victim of hate crimes and arson. The campaign raised $102,276 from more than 2,000 donors.
In The People v. Avonte Ahikim Hartsfield, D084114, California Court of Appeals, Fourth District, First Division (September 24, 2025) affirmed the conviction.
FACTS
Investigation and Evidence:
The fire department and police conducted investigations and found that the fire was intentionally set by an open flame. Surveillance footage placed Hartsfield near the scene at the time of the fire. ...
ZIFL Volume 29, Issue 19
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Read the full article at https://lnkd.in/gXNZQBRy, sSee the full video at https://lnkd.in/gygJwCG9 and at https://zalma.com/blog.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
The Contents of the October 1, 2025 Issue of ZIFL Includes:
Another Anniversary -- October 1, 1979 - 2025 -
Forty five years ago today I left the world of the employed and became an entrepreneur by opening my own law firm. The law practice was incorporated shortly thereafter as Barry Zalma, Inc. When I opened for business on October 1, 1979, I had no clients and no certainty that I would have any in the future. I had borrowed money from the bank to carry me through the first six months and was concerned about my ...
Only Vehicles Listed on Policy as a “Covered Auto” Are Entitled to Defense or Indemnity
Post 5198
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ATV Not a Covered Auto
In Acuity, a Mutual Insurance Company v. Peak View Roofing Co., Jeffrey Pierce, and Ty Smith, Civil Action No. 24-cv-01300-MDB, United States District Court, D. Colorado (September 23, 2025) resolved an insurance coverage dispute concerning the duty of the insurer to defend a civil lawsuit.
KEY FACTS:
Parties Involved:
The case involves Plaintiff Acuity, Defendant Smith, Defendant Pierce, and Peak View Roofing Co. (PVRC).
Underlying Action:
Defendant Smith alleges he was injured on August 19, 2022, while riding as a passenger in a 2018 Polaris Rzr ATV owned by Bluethread Services, LLC d/b/a Peak View Roofing, LLC and operated by Defendant Pierce.
Insurance Policy:
The Rzr was insured under the Policy as ...
How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma
See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.
The Dishonest Chiropractor/Physician
How a Need for Profit Led Health Care Providers to Crime
See the full video at and at
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
How Elderly Doctors Fund their ...
How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma
See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.
The Dishonest Chiropractor/Physician
How a Need for Profit Led Health Care Providers to Crime
See the full video at and at
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
How Elderly Doctors Fund their ...
Barry Zalma: Insurance Claims Expert Witness
Posted on September 3, 2025 by Barry Zalma
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit
© 2025 Barry Zalma, Esq., CFE
When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.
On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...
