Pain points in medical-legal claims, do reinsurers and MGAs face similar issues?

I've been researching bottlenecks and pain points in the insurance industry around medical-legal claims, mostly in P&C but also touching life and health lines. It's pretty clear this industry has a lot of friction, mostly because everything runs on traditional, legacy platforms and manual workflows.

From what I've seen on the carrier and TPA side, adjusters are overwhelmed by massive medical files, billing anomalies get missed, and there's no good way to quickly verify whether the medical evidence actually supports a settlement number.

I feel like reinsurers and MGAs probably face similar issues but I'm not as familiar with how it plays out on their side. From my research it seems like reinsurers have very limited visibility into the actual medical records behind the settlements they're paying for, and casualty-focused MGAs don't always have the resources to properly review complex medical files but are under growing pressure from capacity providers on claims quality.

Is that accurate? What am I missing? Would love to hear from anyone who works in or around these areas about where the real bottlenecks are when medical evidence is involved.