Filing a Claim

You may file your Claim Form online or you may generate a personalized Claim Form to print and mail using this website.

Class Members who wish to file a claim must complete this form online or by mail postmarked by the later of February 1, 2016 or 60 days after your Original Coil is replaced by installation of a Replacement Coil in order to be considered for benefits.

For detailed instructions on how to file a claim, please click here.

If you received a Postcard Notice, you have been assigned a Claim Number. To see where the Claim Number is located on the Postcard Notice, click here.

What would you like to do?

I have a claim number and I would like to securely file a claim online.
I have a claim number and I would like to download a personalized claim form, print it out, and mail it in.
I DO NOT have a claim number, but I would like to file a claim online.
I DO NOT have a claim number, but I would like to download a personalized claim form, print it out, and mail it in. (You will only be asked to supply contact information.)

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