File A Claim Form

If you filed a Claim in the 2019 Lloyd’s Settlement,
you are not required to resubmit a Claim.



If, however, you have an additional claim against the Defendant from March 25, 2019, to June 15, 2023, you may file an additional claim to supplement your original claim.



If you are a Settlement Class Member as defined in 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 in the Notice where the coverage incepted or renewed during the period January 1, 1997, through June 15, 2023, 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 December 21, 2023.

The Date to File an Online Claim Form has Passed.

To download a Claim Form, click here

Mailing Address

Syndicate Settlement
c/o A.B. Data, Ltd.
P.O. Box 173075
Milwaukee, WI 53217


RESPONSE DUE DATE: Postmarked or Submitted Online by December 21, 2023

Please note, if you filed a Claim in the 2019 Lloyd’s Settlement, you are not required to resubmit a Claim.

If, however, you have an additional claim against the Defendant from March 25, 2019, to June 15, 2023, you may file an additional claim to supplement your original claim.

Note: These documents are in PDF format. To view the
documents, you will need Adobe Acrobat Reader on your computer or other internet-enabled device.

Adobe Acrobat Reader