My client's use case: we have multiple hospitals that need to share confidential information, for example a patient intake survey that is essentially a typical web form. We need somewhere to store that data.
Building the AWS site to do this took upwards of 1000 person-hours to figuring out HIPAA-compliance issues. This will continue to be an ongoing cost for us, because HIPAA is an ongoing law and it changes sometimes. It takes substantial auditing time and money.
TrueVault would save us all that.