Adlouni v. UCLA Health System Auxiliary, et al. Case No. BC 589243
Submit a Claim - Instructions
If you are a current or former patient at UCLA Health, you may be able to receive benefits from this settlement. You are eligible to do the following:
Submit an ID Experts Enrollment Form to receive two years of free credit monitoring, identity theft protection and insurance. You must enroll online or by mail no later than September 16, 2019. To review a detailed explanation of the services provided in your eligible free, two-year MyIDCare Identity Protection Service package, please click here.
Submit an Unreimbursed Loss Claim Form if you incurred any losses that resulted from identity theft or the unauthorized use of your personally identifiable information including your health information. You may be entitled to receive up to $20,000.00 for unreimbursed losses. Examples of reimbursable losses include charges, late fees, declined payment fees, overdraft fees, returned check fees, and any other losses that could have resulted from the cyberattack on the UCLA Health Network. You can be reimbursed for the time you spent addressing these issues up to six hours at $15 per hour. You must submit an Unreimbursed Loss Claim Form online or by mail no later than June 18, 2021.
Submit a Preventive Measure Claim Form if, after learning of the cyberattack on UCLA Health Network, you incurred costs to prevent identity theft. You may be entitled to receive up to $5,000.00 for reimbursable costs. Examples of reimbursable costs include costs incurred for credit monitoring or reporting, the purchase of identity theft protection, card cancellation or replacement, freezes or alerts on credit reports, and costs to replace driver’s license, ID card or Social Security number. You must submit a Preventive Measure Claim Form online or by mail no later than June 18, 2019.
You are eligible to submit one of each Claim Form, but they must be completed and submitted no later than the due dates as described above. Forms received after these deadlines will be deemed untimely and may not be accepted.