GENERAL INSTRUCTIONS
ATTENTION: This Claim Form may be used by individuals who received direct notice from Air Methods, LLC (“Air Methods” or “Defendant”) that their Personal Information may have been implicated in a November 2023 security incident in which a criminal third-party stole a laptop that may have contained patient information (“Security Incident”). All Settlement Class Members are eligible to claim: (i) up to two thousand five hundred dollars ($2,500) reimbursement of documented out-of-pocket losses that are reasonably traceable to the Security Incident (“Documented Out-of-Pocket Losses”); (ii) a pro rata cash payment estimated to be seventy-five dollars ($75) (“Pro Rata Cash Payment”); and (iii) two years of Identity Defense Total Credit Monitoring (“Credit Monitoring”).
To submit a Valid Claim, you must have been identified as a Settlement Class Member and received Postcard Notice of this Settlement with a Unique ID number and PIN. You are a Settlement Class Member if you received direct notice that your Personal Information may have been implicated in the Security Incident. Your Unique ID and PIN were provided in the Notice you received.
You may file a claim for reimbursement for Documented Out-of-Pocket Losses. Documented Out-of-Pocket Losses consist of actual, documented out-of-pocket monetary losses, up to two thousand five hundred dollars ($2,500).
In addition to seeking reimbursement for Documented Out-of-Pocket Losses, you may also make a claim for a Pro Rata Cash Payment estimated to be seventy-five dollars ($75).
In addition to the Documented Out-of-Pocket Losses and Pro Rata Cash Payment, you may also make a claim for two years of Credit Monitoring.
PLEASE BE ADVISED that any documentation you provide in support of your Documented Out-of-Pocket Losses claim must be submitted WITH this Claim Form. No documentation is required for claiming the Pro Rata Cash Payment or the Credit Monitoring.
CLAIM VERIFICATION: All claims are subject to verification. You will be notified if additional information is needed to verify your claim.
ASSISTANCE: If you have questions about this Claim Form, or lost your Unique ID and PIN, please contact the Settlement Administrator at info@AirMethodsSettlement.com or call 866-610-9306.
PLEASE KEEP A COPY OF YOUR CLAIM FORM AND PROOF OF MAILING FOR YOUR RECORDS.
Failure to submit required documentation, or to complete all parts of the Claim Form, may result in denial of the claim, delay its processing, or otherwise adversely affect the claim.