Your claim must be submitted online or postmarked by March 6, 2025.
GENERAL INSTRUCTIONS
You are included in the Settlement Class if you received a Notice Letter from Ardent Health Services (“AHS”) notifying you that your private information was compromised in the "Data Incident". Excluded from the Settlement Class are: (a) all persons who are employees, directors, officers, and agents of AHS, the Judge assigned to the Action, and that Judge’s immediate family and Court staff.
The "Data Incident" is the targeted cyberattack on the AHS’s computer systems that occurred on or about November 23, 2023, in which certain files that contained private information were accessed.
COMPLETE THIS CLAIM FORM IF YOU ARE A CLASS MEMBER AND WISH TO RECEIVE ONE OR MULTIPLE OF THE FOLLOWING SETTLEMENT BENEFITS.
AVAILABLE BENEFITS
You are not limited to one benefit. If you are eligible for multiple benefits, as described below, you may file a claim for each of them.
Identity Theft Protection and Credit Monitoring: All Class Members may claim one year of Identity Theft Protection and Credit Monitoring provided by a credit monitoring bureau. This protection includes up to $1 million in identity theft insurance. Class members who submit a valid Claim for Reimbursable Out-of-Pocket Expenses may claim two years of Identity Theft Protection and Credit Monitoring.
Cash Payment: All Class Members may claim a Cash Payment. Class Members whose SSNs were not accessed in the Data Incident will receive a payment of $25.00. Class Members whose SSNs were accessed in the Data Incident will receive a payment of $75.00.
Reimbursable Out-of-Pocket Expenses: Class Members may submit a Claim for reimbursement of documented out-of-pocket losses reasonably traceable to the Data Incident. The maximum amount for this reimbursement is $1,000.00 per Class Member for Class Members whose SSNs were not accessed in the Data Incident, and $5,000.00 per Class Member for Class Members whose SSNs were accessed in the Data Incident. Out-of-Pocket Expense claims may be combined with Cash Payment claims, up to the maximum amount. Out-of-Pocket Expense must have occurred between November 23, 2023, and March 6, 2025, and may include:
unreimbursed bank fees;
long distance phone charges (only if charged by the minute);
cell phone charges (only if charged by the minute);
data charges (only if charged based on the amount of data used);
postage;
notary fees;
unreimbursed losses due to fraud or identity theft; and/or
other charges or losses reasonably related to the Data Incident
You must submit documentation, such as receipts, to verify the costs you incurred. You may submit “self-prepared” documents to add clarity or support to other submitted documentation, but self-prepared documents by themselves are not sufficient to file a valid claim.
he amount of the Cash Payments and the maximum amount for Reimbursable Out-of-Pocket Expenses depend on whether or not your Social Security Number (“SSN”) was accessed in the Data Incident. If you have questions about whether or not your SSN was accessed, please contact the Settlement Administrator.
THE EASIEST WAY TO SUBMIT YOUR CLAIMS IS ONLINE.
To start your online claim form, please login using the Claim Login ID & PIN printed on the Notice that was sent to you. If you are unable to locate your ID & PIN, please contact us at (866) 675-2430 or by emailing info@AHSClassActionSettlement.com. Please request your Claim Login ID & PIN by providing the your full name and mailing address.
You may also download, print out and complete the Claim Form and submit it by U.S. mail to AHS Data Incident Settlement, c/o Settlement Administrator, P.O. Box 25226, Santa Ana, CA 92799-9966. An electronic image of the completed Claim Form can also be submitted by email to info@AHSClassActionSettlement.com.
The deadline to submit a Claim Form online is March 6, 2025. If you are mailing your Claim Form, it must be mailed with a postmark date no later than March 6, 2025.