Death is both predictable and often financially devastating for relatives. Armed with actuarial and compound interest tables, life assurance has thus grown into a multi-trillion dollar business worldwide. But in the US, decay is often more ruinous than death, creating a large and largely unmet insurable need.

A lack of social programmes and the fact that multiple generations rarely live together have caused the cost of long-term care to rise to 1.2 per cent of gross domestic product – a figure that may triple in coming decades as baby boomers with ever-longer life expectancies swell the ranks of retirees. As government programmes will only pay for long-term care once all other financial resources have been exhausted, about one-third of costs are paid out-of-pocket. Long-term care insurers tried to fill the gap in the 1990s and failed miserably.