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This study aims to assess how ethical sales behaviour affects switching costs typology, mediated by trust and moderated by brand affiliation, monthly contributions and the number of dependent beneficiaries in medical schemes in South Africa.

A quantitative study targeted a non-probability judgement sample of 250 main members of medical schemes, elicited near health-care facilities in South Africa’s Gauteng province. Data was collected in a face-to-face survey and analysed using structural equation modelling on AMOS version 29 and PROCESS procedure for Statistical Package of Social Science release 2.041.

The results show that ethical sales behaviour negatively affects trust and positively affects evaluation, monetary and personal relational loss costs. Trust positively affects personal relational loss costs, economic risk, evaluation, monetary and benefit loss costs. Moreover, trust mediates the effect of ethical sales behaviour on evaluation, monetary and personal relational loss costs. Finally, the number of dependent beneficiaries, monthly contributions and brand affiliation significantly moderate these interactions.

The paper validates the application of commitment-to-trust theory in mediating how the effects of the general theory of marketing ethics on switching costs typology differ according to the number of dependent beneficiaries, monthly contributions and brand affiliation with medical schemes.