Submit a Claim - Claim Instructions

The Claim Form is to be used to apply for benefits from the Settlement of a lawsuit with Community Health Systems Professional Services Corporation n/k/a CHSPSC, LLC (“CHSPSC”) as a result of an external criminal-cyberattack on CHSPSC’s computer network in April and June 2014, publicly announced on August 18, 2014 (the “Security Incident”). To recover as part of this Settlement, you must provide the information requested in this Claim Form for each applicable claim. PLEASE BE ADVISED that any documentation you provide must be submitted with this Claim Form.

There are two types of claims, Response Expense Reimbursement and Fraud Loss Reimbursement, that you can file for. Please review the information below. You may make a claim for one or the other, or both.

The only way to receive payment is to file a claim via this website or by U.S. mail. Claim forms must be submitted online or postmarked no later than August 1, 2019.


Response Expense Reimbursement

Class Members who had out-of-pocket expenses and documented lost time, for the following categories, resulting from the Security Incident are eligible to make a claim for reimbursement (subject to a maximum limit of $250).


Response Expense Supporting Documentation
The costs of credit monitoring and identity theft protection services you purchased between August 18, 2014 and August 1, 2019 Receipt or other proof of purchase for each product purchased
Hours of documented lost time spent dealing with the Security Incident or alleged identity fraud that resulted from the Security Incident calculated at the rate of $15.00 per hour Proof of your time spent
The costs of credit report(s) you purchased Receipt or other proof of purchase
Other incidental expenses attributable to the Security Incident Proof that you will specify on the Claim Form to prove the other incidental expenses you incurred

Fraud Loss Reimbursement

Class Members who had monetary out-of-pocket losses attributable to actual identity fraud and/or identity theft that occurred as a result of the Security Incident are eligible to make a claim for reimbursement(subject to a maximum limit of $5,000).

You will be required to provide detailed records of the documented unreimbursed monetary losses you incurred and you must be able to provide proof that you will specify on the Claim Form to prove that the out-of-pocket losses occurred.



Documentation Documentation must be provided to support your claim as applicable. Documents should be clear, readable copies, as anything you submit will not be returned to you. If you are filing online, please have this information ready before you start to file, as your Claim will not be saved if you have to come back and finish at a later time.



File Online:

After clicking the button below, you will be asked to provide your contact information, then you will be able to select the type of claim you wish to file. Please have all your documentation ready as your Claim will not be saved if you have to come back and finish at a later time. You will also be required to provide the Unique ID you received with your Postcard Notice. If you did not receive a Postcard Notice or have lost yours, please contact the Settlement Administrator.


Start Your Claim Form
File by Mail:

If you would like to file by mail, download a copy of the Claim Form here. Please read the form carefully, fill it out completely, and attach any documentation as applicable. Then, mail the completed Claim Form to the following address:

CHSPSC Settlement
Settlement Administrator
P.O. Box 6336
Portland, OR 97228-6336


Remember, all Claims must be submitted online or postmarked no later than August 1, 2019.