A specialty insurer triples adjuster throughput on complex claims with a multi-agent triage and investigation stack.
Apex's complex-claims unit was understaffed, with a queue of high-severity cases growing faster than adjuster capacity. Average loss-adjustment expense was rising, and combined-ratio pressure made traditional staffing expansion a non-starter.
Synaptix built a claims triage and investigation agent stack: an intake agent normalizes FNOL, a coverage-analysis agent matches policy language, an investigation agent runs SIU-style red-flag detection across documents and prior claims, and a recommendation agent produces a draft reserve and next-best-action for the adjuster. Human-in-the-loop on every payment decision.
"We expected efficiency gains. We didn't expect the SIU precision lift — that paid for the program in the first year."
How a regional health plan moved from 6-day to 14-minute median prior authorization turnaround with a multi-agent reference architecture.
Read →A Tier-1 European bank cuts its KYC backlog 70% with a continuous, evidence-grounded multi-agent review system.
Read →A global pharma cuts MLR review cycles 64% with an evidence-grounded, regulator-defensible agent stack across 14 markets.
Read →Ready to operationalize your agents?
Talk to our team about a pilot on Synaptix Cloud or on-prem.