AS
Apex Specialty Insurance
Insurance · Specialty

A specialty insurer triples adjuster throughput on complex claims with a multi-agent triage and investigation stack.

3.4×
Adjuster throughput on complex claims
↓ 22%
Loss-adjustment expense per case
+1.8 pts
SIU referral precision
The challenge

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.

The solution

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."

Priya Banerjee, SVP Claims, Apex Specialty
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