Submit a Claim - Claim Instructions

If you are an individual who was notified that your Personal Information was potentially compromised as a result of a network security incident (the “Incident”) impacting Essen Medical Associates, P.C. (“Essen”) computer systems, you are a Settlement Class Member.

Claim Forms must be submitted online by June 1, 2026 or postmarked (if mailed) by June 1, 2026.

As a Settlement Class Member, you are eligible to make a claim for

(1) up to a $5,000.00 cash payment for reimbursement of Documented Losses, the exact amount of which will depend on the extent to which Documented Losses are supported by Reasonable Documentation and determined by the Settlement Administrator to be more likely than not a result of the Incident, and not otherwise reimbursable by insurance (“Documented Loss Payment”);

AND/OR

(2) a pro rata Cash Fund Payment of up to $100.00, the exact amount of which will depend on the number of Settlement Class Members who participate in the Settlement. Cash Fund Payments may be reduced or increased pro rata (proportional share), depending on how many Settlement Class Members submit claims.

Please complete a Claim Form on behalf of the individual who received a notification from Essen Medical Associates, P.C. If you are the parent of a minor(s) who received a breach notification, please submit the form using the information of the minor(s), submitting one Claim Form per individual.


How to File Online:

Before Claim Filing: You will need the Unique ID printed on the Postcard Notice you received in the mail. If you did not receive a Postcard Notice or have lost yours, please contact the Settlement Administrator at 1-888-976-6880 for assistance.

During Claim Filing: : As part of filling out your Claim Form, you will be asked to verify information associated with the losses claimed. You must also submit all required supporting documentation if submitting a claim for Documented Losses. Documents supporting your claim could include credit card statements, bank statements, invoices, telephone records, or receipts. Documented Losses cannot be documented solely by a personal certification, declaration, or affidavit from you. Supporting documentation should be clear, readable copies. Please keep copies of everything you submit, as your claim may be audited, and you could be asked to provide additional information to process the claim.

After Claim Filing: After submitting your completed claim online, you will receive an email with a confirmation code for your completed submission. Be sure to keep your confirmation email and code and refer to them if you have any questions about your Claim Form.

Please use the login below to get started.


Submit a Claim Form - Login
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How to File by Mail:

Fill out, sign, and date the Claim Form, then mail the Claim Form to the following address:

Essen Medical Data Breach
Settlement Administrator
P.O. Box 2020
Portland, OR 97208-2020


Remember, all Claim Forms must be submitted online or postmarked by June 1, 2026.