Blackstone Valley Community Health Care Data Breach Settlement

1. Locate the settlement notice letter you received from BVCHC — it contains your login ID and PIN needed for the online claim form.
2. Go to the claim URL (blackstonevalleysettlement.com/form/claim) and log in with your notice ID and PIN, OR print the PDF claim form and complete it by hand.
3. Select which benefit(s) you want: credit monitoring, ordinary out-of-pocket expenses, extraordinary identity theft losses, and/or lost time.
4. Gather and attach supporting documentation for any expenses or losses you are claiming (receipts, bank statements, invoices, police report, etc.).
5. For a lost-time claim, write a description of what time you spent dealing with the breach.
6. Submit online, or mail/email the completed form with documentation to the settlement administrator before the claim deadline.
7. Choose your preferred payout method: PayPal, Venmo, Zelle, virtual prepaid card, or paper check.

What the form asks

• — The login ID and PIN found in your individual settlement notice letter from BVCHC. (Printed in the notice letter mailed to you by BVCHC.)
• — Total documented expenses (fees for credit reports, credit monitoring, freezing or unfreezing credit, replacing IDs, postage for contacting financial institutions) with receipts attached. (Your receipts, invoices, and bank/card statements from the period after the breach.)
• — Description and dollar amount of unreimbursed losses due to identity theft or fraud, with documentation showing you tried to recover through insurance or other means. (Bank or credit card statements, police reports, invoices for services, and any insurance claim records.)
• — A description of the time you spent dealing with the data breach (e.g., changing passwords, investigating suspicious activity, researching the breach), up to four hours. (Your own recollection of activities performed after learning of the breach.)
• — Choose one: PayPal, Venmo, Zelle, virtual prepaid card, or paper check. (Your preference; have the relevant account details ready.)

Documents you'll need

Watch out for

• Online claims require the login ID and PIN printed in the individual notice letter BVCHC mailed you — you cannot file online without it.
• Self-created notes alone are insufficient to support expense claims; you need receipts or personal documentation showing expenses were caused by the Data Incident.
• Extraordinary expense claims require proof that you attempted to recover losses through other means (such as insurance) before claiming from this settlement.
• The settlement has not yet received final court approval; payments will only be issued after the court grants final approval.