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Coronial inquests

An inquest is a public hearing conducted by a coroner.

An inquest is a public hearing conducted by a coroner. In Melbourne, inquests are held in the Coroner's Court at the Coronial Services Centre. In regional Victoria, inquests are held at the local Magistrates' Court.

Only a small number of coronial investigations result in an inquest. Most investigations are finalised based on a review of the available evidence.

See Investigating a death

Request for an inquest

A person can ask the coroner to hold an inquest into any death that has been reported to the coroner. The coroner has 3 months to respond to this request.

When an inquest is conducted

A coroner who has jurisdiction to investigate a death must hold an inquest if the body is in Victoria or it appears to the coroner that the death, or the cause of death, occurred in Victoria and the:

  • coroner suspects homicide
  • deceased was in care immediately before the death
  • identity of the deceased is not known
  • death occurred in prescribed circumstances (that is, conditions prescribed in the regulations)
  • Attorney-General or state coroner directs it
  • person has been placed in custody or care immediately before their death, or
  • coroner thinks an inquest is desirable.

See s. 52—Coroners Act 2008 (Vic)(opens in a new window).


The coroner need not investigate the death of a person who was in care or custody immediately before they died, if the coroner is satisfied that the person died from natural causes.

See ss. 52(2)(b), 52(3A)—Coroners Act 2008 (Vic)(opens in a new window).

What is custody or care?

The new Act has a broader definition of a person placed in custody or care. It includes a person who:

  • was attempting to escape custody
  • the police were trying to apprehend.

Deceased ordinarily resident in Victoria

The Attorney-General may direct the state coroner or a coroner to hold an inquest into a death that occurs outside Victoria where the deceased ordinarily resided in Victoria at the time of death.


The coroner does not have to hold an inquest if the death happened 50 years or more before it was reported.

Findings and comments of the coroner

When a coroner investigates a death, they must find where possible:

A coroner may comment on any matter connected with the death including:

  • public health
  • public safety, and
  • administration of justice.

A coroner must not include in a finding or comment any statement that a person is or may be guilty of an offence.

A coroner must report to the Director of Public Prosecutions if they believe that an indictable offence has been committed in connection with a death.

More information


Coroners Act 2008 (Vic)

  • Part 5—inquest
  • s. 3—defines an inquest
  • s. 52—when a coroner may hold an inquest into a death
  • s. 55—power of coroners at inquests
  • Part 6—the coroner's findings recommendations and referrals
  • s. 67—allows the coroner to comment on any matter connected with the death.

See Coroners Act 2008 (Vic)(opens in a new window).

Births, Deaths and Marriages Registration Regulations 2019 (Vic)

  • r. 8—particulars to be specified by doctors in death notices

See Births, Deaths and Marriages Registration Regulations 2019 (Vic).(opens in a new window)