REIMBURSEMENT FOR OUT-OF-POCKET LOSSES. In the alternative to Expanded Identity Theft and Fraud Monitoring Services, you may elect to submit a Claim Form for reimbursement of certain Out-of-Pocket Losses. If you spent money remedying or addressing identity theft and fraud that was more likely than not related to the Connexin Data Security Incident or you spent money to protect yourself from future harm because of the Connexin Data Security Incident, you may make a claim for a Reimbursement for Out-of-Pocket Losses for reimbursement of up to $7,500.00 in Documented Losses. Out-of-Pocket Losses consist of unreimbursed losses incurred on or after August 26, 2022, that were related to identity theft and fraud and are more likely than not a result of the Connexin Data Security Incident, as well as any expenses related to the Connexin Data Security Incident. For example, long distance telephone charges; cell phone minutes (if charged by the minute); internet usage charges (if either charged by the minute or incurred solely as a result of the Data Security Incident); costs of credit reports purchased between August 26, 2022 and the Claims Deadline; documented costs paid for credit monitoring services and/or fraud resolution services purchased between August 26, 2022 and the Claims Deadline, provided you provide a sworn statement that the monitoring or service was purchased primarily because of the Data Security Incident and not for other purposes; documented expenses directly associated with dealing with identity theft or identity fraud related to the Data Security Incident; other document losses that are more likely than not related to the Data Security Incident; and compensation for hours of lost time spend dealing with the Data Security Incident $30/hour, up to five (5) hours maximum per settlement class member (“Attested Lost Time”). Other losses or costs related to the Connexin Data Security Incident that are not insurance reimbursable may also be eligible for reimbursement. To protect the Settlement Fund and valid claims, all Claim Forms submitted that seek payment related to credit or debit card fraudulent transactions will be carefully scrutinized by the Settlement Administrator. Claims for Reimbursement for Out-of-Pocket Losses must be supported by Reasonable Documentation. Reasonable Documentation means written documents supporting your claim, such as credit card statements, bank statements, invoices, police reports, telephone records, and receipts. Claims for Reimbursement for Attested Lost ...
REIMBURSEMENT FOR OUT-OF-POCKET LOSSES. Data Incident Settlement Class Members whose information was maintained on Defendant Lifescan’s computer systems and/or network that was impacted in the Data Incident may submit a Claim Form for reimbursement of documented Out- of-Pocket Losses, not to exceed $3,000 per Settlement Class Member, that was for a monetary Out-of-Pocket Loss incurred as a result of the Data Incident if: (a) it is an actual, documented, and unreimbursed monetary loss; (b) it was more likely than not caused by the Data Incident; (c) it occurred during the Claims Period, through and including between October 3, 2021 and the end of the Claims Deadline; and (d) the claimant made reasonable efforts to avoid, or seek reimbursement for, the loss. Generally, an Out-of-Pocket Loss is unreimbursed financial loss as the direct result of financial fraud or stolen identity. You must submit documentation to obtain this reimbursement. This can include receipts or other documentation not “self-prepared” by the claimant that documents the costs incurred. “Self-prepared” documents such as handwritten receipts are, by themselves, insufficient to receive reimbursement, but can be considered to add clarity or support other submitted documentation. □ I have attached documentation showing that the claimed losses were more likely than not caused by the Data *0000000000000* LIFESCAN-C Your claim must be submitted online or postmarked by: <<Claims Deadline>> CLAIM FORM FOR LIFESCAN LABS DATA INCIDENT AND BIPA SETTLEMENT Xxxx v. Lifescan Labs of Illinois, LLC Case No.: 2023LA44 In the Circuit Court of the Fourteenth Judicial Circuit Whiteside County, Illinois Incident. Questions? Go to xxx.xxxxxxxxxxxxxxx.xxx or call (XXX) XXX-XXXX. *73135* *CF* *Page 3 of 65* 73135 CF Page 3 of 65 Examples of such losses include unreimbursed payments for identity theft protection or credit monitoring services and financial losses due to stolen identity incurred as a result of the Data Incident, etc. These are only examples and do not represent a complete list of losses eligible for compensation. Please provide a description of any loss that you claim was incurred as a result of the Data Incident. – – $ ● MM DD YY $ ● MM DD YY $ ● $ ● $ ● MM DD YY $ ● MM DD YY $ ● MM DD YY $ ● MM DD YY YY DD MM 1 0 3 2 0 Copy of the professional services bill $25.00 Example: Xxxx paid to a professional to remedy a falsified tax return YY DD MM Copy of identity theft protection service bill $50.00 0 – 1 – 0 Example: Identity Theft Protecti...
REIMBURSEMENT FOR OUT-OF-POCKET LOSSES. Class Members may submit a claim for Out-of-Pocket Losses up to One Hundred-Fifty Dollars and Zero Cents ($150.00) per Class Member that have not been reimbursed through any other source by submitting the Claim Form by the Claim Deadline.
REIMBURSEMENT FOR OUT-OF-POCKET LOSSES. If you incurred expenses that are actual, documented and traceable to the Data Security Incident, such as money spent remedying identity theft or identity fraud or freezing/unfreezing credit reports with any credit reporting agency, you can be reimbursed up to $150. You must submit documents supporting your claim, including exhaustion of all available credit monitoring and identity theft insurance.
REIMBURSEMENT FOR OUT-OF-POCKET LOSSES. Settlement Class Members may submit a claim for Out-of-Pocket Losses up to $5,000 per Settlement Class Member that have not been reimbursed by insurance provided through Experian IdentityWorks℠ (see Paragraph 28(b)(iii)) by submitting the Claim Form (Other Benefits) by the Claim Deadline (Other Benefits).
REIMBURSEMENT FOR OUT-OF-POCKET LOSSES. In addition to Credit Monitoring & Insurance Services, you may also seek reimbursement for up to $10,000 of Out-of-Pocket Losses you incurred that are plausibly traceable to the Security Incident. Out-of-Pocket Losses include, for example: late fees, declined payment fees, overdraft fees, returned check fees, customer service fees, card cancellation or replacement fees, credit-related costs related to purchasing credit reports, credit monitoring or identity theft protection, costs to place a freeze or alert on credit reports, costs to replace a driver’s license, state identification card, or social security number, which are attributable to the Security Incident. In order to make a claim for Out-of-Pocket Losses you must (i) fill out the information below and/or on a separate sheet submitted with this Claim Form; (ii) sign the attestation at the end of this Claim Form (section VII); and
