Dealing with a denied insurance claim is extremely frustrating. Whether you’re dealing with roof damage from a storm, water intrusion from a burst pipe, or loss from theft or fire, having your claim denied feels like a gut punch during an already stressful situation.
Don’t panic. If your insurance company has rejected your claim, it doesn’t always mean the process is over. In fact, homeowners often succeed when they appeal a denied insurance claim, especially when the denial stems from an error, missing information, or a misunderstanding of their Utah homeowner insurance policy.
In this guide, we’ll break down exactly what to do after a claim denial, how to make your case, and what steps to take to protect yourself going forward.
Understand the reason for the claim denial
The first step is to understand the reason behind the denial. The law requires insurance providers to explain their decision, typically in a denial letter or notice. That explanation is more than a formality. It holds the key to determining your next move.
Several common factors may cause your home insurance provider to deny a claim, including damage that is not covered, missed deadlines, incomplete paperwork, or insufficient documentation. Sometimes, insurance providers deny claims because of policy exclusions, lapses in coverage, or disputes over whether the damage is new or pre-existing.
Take time to read the denial letter carefully. If the reasoning seems vague or confusing, it’s completely appropriate to call your insurance company and ask for a more detailed explanation.
Maintain a calm and professional tone, and document all correspondence, including names, dates, and the topics discussed. Knowing exactly why your insurance company denied your claim will help you decide whether appealing a denied insurance claim is worth it.
Review your policy and gather evidence
Next, review your Utah homeowner’s insurance policy carefully. Start with the declarations page, where you’ll find your coverage limits, deductibles, and any endorsements you may have added.
Then look at the fine print — specifically, what perils are covered, what exclusions apply, and whether you had optional coverages like flood, earthquake, or sewer backup.
Compare what’s outlined in your policy to the reason for the denied claim. Sometimes the denial is valid due to coverage gaps, but at other times, important details get overlooked or misinterpreted.
At this stage, gather everything you submitted in your original claim — photos, receipts, inventory lists, contractor quotes, and any communication you had with adjusters or agents. You’ll need all of it if you plan on appealing a denied insurance claim.
Talk to your insurance provider
Once you’ve reviewed your documentation and feel like you have a better understanding of your policy, reach out to your insurance company. Politely ask for clarification on the denial and how it was determined. Use the opportunity to ask whether there’s an internal appeal process and what steps you need to take to begin it.
This phone call can be more productive than you might expect. Sometimes, insurance providers deny claims because missing paperwork, miscommunication, or simple misunderstandings lead them to do so — issues that are often easy to resolve.
Whether or not the conversation changes the outcome, it prepares you for what comes next and shows the insurer that you’re proactive and serious about resolving the issue.
File an appeal
If you still believe the denial was unjustified, you have every right to challenge it by appealing your denied insurance claim. Most insurance providers offer a formal appeals process. You must follow their procedures closely, including any applicable deadlines and specific requirements.
Start by writing a clear, factual letter explaining why you disagree with the denial. Reference the specific part of your policy that supports your claim, and include any new documentation or third-party estimates that reinforce your position.
Be concise, organized, and professional — emotions won’t help your case, but solid evidence will. It’s also wise to keep a record of when and how you submit your appeal in case you need to escalate it further.
Get a second opinion
If you’re not confident in the findings of your insurer’s claims adjuster, it may be worth getting a second opinion from a qualified, independent contractor or home inspector. They provide a fresh assessment of the damage, which may help support your appeal or dispute the original report.
This is particularly helpful in Utah homeowner insurance cases where weather-related damage (like snow load, ice dams, or sudden water intrusion) is easily confused with long-term wear and tear.
A professional evaluation may come at a small cost, but it could strengthen your position and tip the scales in your favor during the appeal.
Consider hiring a public adjuster
If the situation becomes more complex — or if the potential payout is significant — you may want to hire a public adjuster. Unlike the insurance company’s adjuster, a public adjuster works for you, not the insurer. They’re licensed professionals who re-evaluate the damage, handle negotiations, and advocate for a fair settlement on your behalf.
Public adjusters typically charge a percentage of your final claim payout, often around 10%. While this reduces your settlement, many homeowners still consider it worthwhile if their claim was originally undervalued or unfairly denied.
Many homeowners working with Utah homeowner insurance providers have had success overturning low or denied claims with the help of public adjusters who understand local policies and types of damage.
File a complaint if necessary
If you’re not making progress through appeals and feel that your insurer is acting in bad faith, you have the right to file a complaint with your state’s insurance department. For Utah residents, that would be the Utah Department of Insurance.
Filing a complaint may prompt the state to investigate your case, especially if there’s a pattern of poor communication, slow response times, or questionable denials. While it doesn’t guarantee a reversal, this step puts added pressure on the insurer to revisit your claim fairly.
Legal action as a last resort
Taking legal action should be a last resort, but in some cases, it’s necessary — especially if the denied claim involves a significant financial loss. If you’ve exhausted the appeal process and still believe your home insurance provider denied your claim unfairly, speak with an attorney who specializes in insurance disputes.
Many attorneys offer free consultations to determine whether your case has merit without committing to expensive legal fees upfront. This route takes time and effort, but it may be the only way to recover what you’re entitled to under your policy.
How to avoid claim denials in the future
After resolving your current claim, it’s worth taking steps to avoid problems down the line.
Review your Utah homeowner insurance policy every year to make sure it reflects your home’s current value and any upgrades you’ve made. Add endorsements if needed for items such as flood, earthquake, or high-value personal property coverage.
Also, maintain a home inventory with receipts and photos, document everything if damage occurs, and file claims promptly with complete transparency. The more prepared and organized you are, the more likely your insurance provider is to approve your claim without issues.
Take the next steps with Bear River Insurance
When disaster strikes, the last thing you want is uncertainty about your coverage. At Bear River Insurance, we believe peace of mind starts with a policy that truly protects your home — and a team that stands by you when it matters most.
If you’ve experienced a home insurance claim denial, want to make sure your policy is solid from the start, or want to switch coverage, we’re here to help. Don’t leave your biggest investment to chance. Contact Bear River Insurance today to get the dependable Utah homeowner insurance coverage you and your family deserve.