File A Claim
If you are a Settlement Class Member as defined on page 2 of the Notice of Proposed Partial Class Action
Settlement, Settlement Hearing and Right to Appear (“Notice”) with respect to the purchase of insurance coverage
from the Defendants described on page 2 of the Notice where the coverage incepted or renewed during the period
January 1, 1997, through March 25, 2019, you must complete a claim form for each such insurance that you purchased
or renewed and mail it to the address listed below in order to participate in the Settlement for such policies.
This claim form must be postmarked or submitted online by October 25, 2019.