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Welcome to the In Re Columbus Regional Healthcare System Data Security Incident Online Claim Form submission page.

General Instructions:

If you received Notice of this settlement, the Settlement Administrator identified you as a Class Member who may have been involved in the Data Incident and were notified by Columbus Regional Healthcare System that your Private Information may have been impacted as a result of the Data Incident. You may submit a claim for settlement compensation, outlined below.

Please refer to FAQ 6, for more information on submitting a Claim Form and information on the aggregate cap on claims.

Available Benefits:

Compensation for Documented Out-of-Pocket Losses: All Class Members are eligible to recover compensation for up to $5,000 per person for Out-of-Pocket Losses incurred as a result of the Data Incident. Losses include: unreimbursed losses relating to fraud or identity theft; professional fees including attorneys’ fees, accountants’ fees, and fees for credit repair services; costs associated with freezing or unfreezing credit with any credit reporting agency; credit monitoring costs that were incurred on or after May 21, 2023 through April 2, 2025; and miscellaneous expenses such as notary, fax, postage, copying, mileage, and long-distance telephone charges. Class Members submitting claims for Out-of-Pocket Losses must submit documentation supporting their claims by an attestation under penalty of perjury, which is part of this Claim Form.

Pro Rata Cash Fund Payment: All Class Members may also make a claim for a pro rata cash payment from the Settlement Fund. The amount of the pro rata cash payment is estimated to be $50 per claimant. The amount of the Cash Fund Payment may increase or decrease based upon the number of claims approved. The pro rata Cash Fund Payments will evenly distribute the net amount of the $1,175,000 Settlement Fund, after payment of all approved claims for Out-of-Pocket Losses, Notice and Administration Expenses, and any award of attorneys’ fees, expenses, and service awards. Welcome to the

TO BE VALID, THE CLAIM FORM MUST SUBMITTED NO LATER THAN APRIL 2, 2025.

To start your online claim form, please login using the Claim Login ID & Claim Login PIN, which you can found on the Notice sent to you. If you are unable to locate your ID & PIN, please contact us at (866) 675-2690 or by emailing info@ColumbusRegionalDataSettlement.com. Please request your Claim Login ID & PIN by providing the your full name and mailing address.