Claim Form Login
If your Private Information was compromised in the July 2025 Susan B. Allen Memorial Hospital Data Incident and you received written notice of the Data Incident, you may be a Class Member and eligible for Settlement Benefits. Excluded from the Settlement Class are: (1) the Judge in this case, and the Judge’s family and staff; and (2) anyone who perpetrated the Data Incident.
If you are a Class Member and wish to receive Settlement Benefits then you must submit a claim form by November 12, 2026.
All Settlement Class Members may claim Credit Monitoring and Identity Theft Protection Services and one or more of the cash payment options. The benefits are explained in more detail below.
Credit Monitoring and Identity Theft Protection Services. All Class Members are eligible to enroll in two (2) years of CyEx Medical Shield Complete. This comprehensive service comes with $1 million of medical identity theft insurance, and includes monitoring for:
healthcare insurance ID exposure
Medical Record Number (MRN) exposure
unauthorized Health Savings Account (HSA) spending
If anything suspicious happens, you will be able to talk to a fraud resolution agent to help fix any problems.
Reimbursement for Attested Time. Class Members who spent time responding to the Data Incident may claim up to four (4) hours, at $25.00 per hour, for a maximum of $100.00. You must have spent the time on tasks related to the Data Incident. Some examples include things like:
Reimbursement for Out-of-Pocket Losses. Class Members who incurred actual, documented out-of-pocket expenses due to the Data Incident, can get back up to $100.00. The losses must have occurred between July 14, 2025, and September 29, and you cannot claim a payment for expenses that have already been reimbursed by a third party. This benefit covers out-of-pocket expenses like:
losses because of identity theft or fraud
fees for credit reports, credit monitoring, or freezing and unfreezing your credit
cost to replace your IDs
postage to contact banks by mail
If you are claiming for Documented Losses, you need to submit proof, like bank statements or receipts, to show how much you spent or lost. You can also provide notes or papers you made yourself to explain or support other proof, but those notes or papers alone are not enough to make a valid claim. Your proof or notes should show that your expenses were because of the Data Incident.
There is an aggregate cap of $100.00 on these benefits. This means that the total amount you can receive for both types of cash claims is subject to a $100.00 aggregate cap.
To start your online claim form, you must login with your LoginID and PIN. You can find your LoginID and PIN on the Notice that was sent to you. If you are unable to locate your ID and PIN, please contact us by emailing info@SBAMHDataSettlement.com. Please request your LoginID and PIN by providing your full name and mailing address.
You may also download a Claim Form here and submit it, along with any supporting documentation, by email or U.S. mail to:
The deadline to submit a Claim Form online or by email is November 12, 2026. If you are mailing your Claim Form, it must be mailed with a postmark date no later than November 12, 2026.