Inquests in the Coroner's Court

Losing a loved one is the most distressing event in our lives. It is even more painful when that loss is sudden, unexpected and without obvious explanation. 

The vast majority of deaths are recorded without intervention by the state, but in a relatively small number of cases, the deaths are investigated by a Coroner.

A Coroner is required, by law, to undertake an inquest into all deaths that are:

  1. a violent or unnatural death,
  2. where the cause of death is unknown,
  3. the deceased died while in custody or otherwise in state detention.

Examples of such deaths can be road traffic collisions, workplace accidents, industrial illness (caused by exposure to substances at work), criminal assaults, deaths while under medical care and suicides.

In most cases the Coroner will be made aware of such a death by the police or doctor.    The Coroner will then, through a Coroner’s Officer and support staff, undertake inquiries in order to carry out an inquest touching the death of the deceased.   There are about 25,000 inquests each year.  Inquests are very important for loved ones, as they can result in a greater understanding of the events and precise mechanism leading to the death and loss.

The Coroner's Court and the key questions which must be answered

Although the Coroner’s Court will hold a public investigation into the death, there are only four questions for the Coroner, with or without a jury, to answer. Those questions are:

  • Who died;
  • When they died;
  • Where they died, and;
  • How they died.

It is the last question that is the most important for the family. The answer is not limited to the medical cause of death, but is by what means they died. In some cases, the Coroner will extend the inquiry to, by what means and in what circumstances the deceased died. 

The Coroner will consider evidence to answer the four questions. That evidence will be a combination of written and spoken evidence, but sometimes just written evidence is considered at the inquest. The Coroner will take account of the post mortem report and any other report provided to the Coroner during the course of the investigation, and any other document that the Coroner considers relevant to the inquest. A Coroner must include in the inquest any document made by the deceased if the Coroner is of the opinion that the contents of the document are relevant to the purposes of the inquest.

In addition the Coroner will have evidence from witnesses, not just those who witnessed the death but, from family members too. The Coroner will decide whether those witnesses should give oral evidence at the inquest, or that those witness statements should be read out in court, which is open to the public to observe.

The Coroner's Conclusion

At the end of the evidence the Coroner will deliver a Conclusion, once called the Verdict. There is a non-exhaustive list of Conclusions, the most common of which are:

  • Accident or misadventure;
  • Alcohol/drug related;
  • Industrial disease;
  • Lawful/unlawful killing;
  • Natural causes;
  • Open;
  • Road traffic collision;
  • Stillbirth;
  • Suicide;

As an alternative, the Coroner, or the jury, may make a brief narrative conclusion.

The standard of proof at the inquest is the civil standard of proof, ie on the balance of probabilities, except for unlawful killing and suicide, which is the criminal standard of proof, ie beyond reasonable doubt.

Coroners have a duty not just to decide how somebody came by their death but also, where appropriate, to report about that death with a view to preventing future deaths. A report will be initiated when a Coroner, during the inquest, becomes concerned by something. The concern is that circumstances creating a risk of further deaths will occur, or will continue to exist, in the future. It is concern of a risk to life caused by present or future circumstances. The Coroner has a duty to report the matter to a person or organisation who the Coroner believes may have power to take action.

Although the Coroner is specifically required to avoid determining questions of criminal or civil liability, it can be the case that other legal proceedings follow an inquest. During an inquest, the evidence may indicate wrong doing by an individual or failings by an organisation, which resulted in the death. In those circumstances it may be that the family of the deceased can launch a successful claim for compensation. Although financial compensation can be no substitute for the loss of a family member, it can provide some comfort and security, particularity where the deceased made a financial contribution to the family home.

Inquests - Frequently Asked Questions

  1. What is an Inquest?
  2. How many Inquests are there each year?
  3. When does an Inquest have to take place?
  4. What is the purpose of an investigation and Inquest?
  5. Who is a Coroner?
  6. Within what timeframe should an Inquest be held?
  7. Who is an Interested Person?
  8. Is an Inquest carried out in private, with just the family and court staff present?
  9. Will there be a jury at the Inquest?
  10. Can I see documents the Coroner will have access to and may use at the Inquest?
  11. Can I question witnesses at an Inquest?
  12. What conclusions may an Inquest reach?
  13. Is there a standard of proof?
  14. Will I find out who is responsible for the deceased’s death?
  15. If failings are identified that caused or contributed to the deceased’s death, what will happen?
  16. Does the family of the deceased need a lawyer to represent them at an Inquest?
  17. Will I have to pay for a Solicitor to represent me at the Inquest?

 

What is an Inquest?

An Inquest is a legal inquiry to ascertain the facts relating to a death.

How many Inquests are there each year?

There were 38,626 inquests opened in 2016, which represents an increase of 18% compared with 2015. This arose because of the increase in the deaths of individuals who are subject to Declaration of Liberty Safeguard authorisations, as all such cases require an inquest to be held.

Not all inquests opened are completed within the same year and note all inquests result in an inquest taking place.

There were 40,504 inquests that had conclusions (verdicts) recorded in 2016, which represented an increase of 5,031 (14%) compared with the previous year. This is the highest number of inquest conclusions since such data was collated (1995).

When does an Inquest have to take place?

A coroner must conduct an investigation into violent or unnatural deaths, deaths where the cause is unknown and deaths which occur in custody or otherwise in state detention. In certain cases this investigation will include the coroner holding an inquest.

Examples of such deaths are road traffic collisions, workplace accidents, industrial illness (caused by exposure to substances at work), criminal assaults, deaths while under medical attention and suicides.

What is the purpose of an investigation and Inquest?

The purpose of an investigation into a person’s death is to ascertain

  1. Who the deceased was;
  2. How, when and where the deceased came by his or her death.

Who is a Coroner?

A Coroner is a lawyer and includes a senior coroner, area coroner, assistant coroner and the Chief Coroner.

Within what timeframe should an Inquest be held?

An inquest must be opened as soon as practicably possible after the date the coroner considers an inquest should be held. The coroner may, during their investigation and before the inquest, hold a pre-inquest review hearing.

A coroner must complete an inquest within six months of the date on which they are made aware of the death, or as soon as is reasonably practicable after that date.

A coroner must notify the next of kin or personal representative of the deceased of the date, time and place of the inquest hearing within one week of setting the date of the inquest hearing. The coroner must also notify any other interested persons who have made themselves known to the coroner of the date, time and place of the inquest hearing within one week of setting the date of the inquest hearing.

Where an inquest hearing is to be held, the coroner must make details of the date, time and place of the inquest hearing publicly available before the inquest hearing commences.

A coroner may adjourn an inquest if the coroner is of the view that it is reasonable to do so. The coroner must inform the next of kin or personal representative of the deceased and any other interested persons who have made themselves known to the coroner as soon as reasonably practicable of the decision to adjourn, the date of the decision to adjourn and the reason for the adjournment.

The coroner must inform the next of kin or personal representative of the deceased and any other interested persons as soon as reasonably practicable of the date, time and place at which an adjourned inquest is to be resumed.

A coroner must adjourn an inquest and notify the Director of Public Prosecutions, if during the course of the inquest, it appears to the coroner that the death of the deceased is likely to have been due to a homicide offence and that a person may be charged in relation to the offence.

Who is an Interested Person?

“Interested person” means a spouse, civil partner, partner, parent, child, brother, sister, grandparent, grandchild, child of a brother or sister, stepfather, stepmother, half-brother or half-sister; and a personal representative of the deceased.

Is an Inquest carried out in private, with just the family and court staff present?

A coroner must open an inquest in public.

Where an inquest hearing is to be held, the coroner must make details of the date, time and place of the inquest hearing publicly available before the inquest hearing commences.

A coroner may direct that the public be excluded from an inquest hearing, or any part of an inquest hearing, if the coroner considers it would be in the interests of national security to do so.

Will there be a jury at the Inquest?

An inquest into a death must be held without a jury unless there is reason to suspect that the deceased died while in custody or other otherwise in state detention, and that either the death was a violent or unnatural one, or the cause of death is unknown.

Other circumstances in which an inquest will be held with a jury is where the death resulted from an act or omission of a police officer, or that the death was caused by a notifiable accident, poisoning or disease, ie a workplace death.

There are less than 500 inquests each year, where the Coroner sits with a jury.

Can I see documents the Coroner will have access to and may use at the Inquest?

Subject to limited exceptions, the coroner must provide the document or a copy of that document they will use, or make the document available for inspection, as soon as is reasonably practicable, if an interested person asks for the document.   

Those documents available will be the post-mortem examination report, any other report that has been provided to the Coroner during the course of the investigation and any other document the Coroner considers relevant to the inquest.

Can I question witnesses at an Inquest?

In addition to the Coroner asking witnesses questions, relating to the death of the deceased, a Coroner must allow any interested person to question any witness either in person, or through their legal representative.

The Coroner will be the first to ask questions of the witness, followed by any interested person and then, if the witness is represented at the inquest, by the witnesses’ representative.

No witness at an inquest is obliged to answer any question tending to incriminate him or her.  Where it appears to the Coroner that a witness has been asked such a question, the Coroner must inform the witness that he or she may refuse to answer it.

A coroner must keep a recording of every inquest hearing, including the pre-inquest review hearing.

What conclusions may an Inquest reach?

Having heard all the evidence the Coroner will deliver a Conclusion, previously called the Verdict. There is a non-exhaustive list of Conclusions, examples of which are:

  • Accident or misadventure;
  • Alcohol/drug related;
  • Industrial disease;
  • Lawful/unlawful killing;
  • Natural causes;
  • Open;
  • Road traffic collision;
  • Stillbirth;
  • Suicide;

Alternatively, the Coroner, or the jury, may deliver a brief narrative conclusion.

In 2016 the most common conclusions were as follows:

  • Death by natural causes (15,962, or 39%)
  • Death by accident or misadventure (7,692, or 19%)
  • Suicide (3,789, or 9%)
  • Unclassified conclusions, including narrative verdicts (5,030, or 12%)

The increase seen in death from natural causes over the last few years is due to people being subject to Deprivation of Liberty Safeguards authorisations.

Is there a standard of proof?

The standard of proof at the inquest is the civil standard of proof. This means “on the balance of probabilities” (more likely than not), except for unlawful killing and suicide, which is the criminal standard of proof, ie beyond reasonable doubt.

Will I find out who is responsible for the deceased’s death?

The purpose of an inquest is to identify who the deceased was, when they died, where they died and how they died. Only those four questions are to be answered at the inquest.

Although the Coroner is specifically required to avoid determining questions of criminal or civil responsibility, it can be the case that other legal proceedings follow an inquest.  During an inquest, evidence may indicate wrongdoing by an individual or failings by an organisation, which resulted in the death.   In those circumstances, it may be that the family of the deceased can launch a successful claim for compensation, after the inquest.

If failings are identified that caused or contributed to the deceased’s death, what will happen?

There are two things that could happen.

First, Coroners have a duty not just to decide how somebody came by their death but also, where appropriate, to report that death with a view to preventing future deaths. A report will be initiated when a Coroner becomes concerned by events surrounding the death. The Coroner has a duty to report the matter to a person or organisation who the Coroner believes may have power to prevent future deaths.

Second, if the deceased’s family consider the evidence reveals someone or an organisation was responsible for the death, they can make a claim for compensation.

Does the family of the deceased need a lawyer to represent them at an Inquest?

No. If you are an interested person you can attend the inquest and ask questions of the witnesses.  You do not have to instruct a Solicitor, but are entitled to do so if you wish.

If you use a Solicitor to act on your behalf at the Inquest, they will ask questions at the Inquest to assist the Coroner. They will also help the family in finding out the circumstances of the deceased’s death.

The Coroner will be the first to ask questions of the witness, followed by any interested person and then, if the witness is represented at the inquest, by the witnesses’ representative.

Will I have to pay for a Solicitor to represent me at the Inquest?

Legal aid (from the Government) to pay for a Solicitor is available, but in very limited circumstances.

The deceased’s family may have legal expenses insurance to cover the legal costs of not only the inquest but also to make a claim for compensation, if the death was caused by someone or an organisation.   The family should speak to their solicitor for advice.

If a claim for compensation is to be made, because others were responsible for the death, the Solicitor may act under a no win, no fee agreement. This means that the family will not have to worry about paying the legal costs of pursuing a claim for compensation if they lose. This type of agreement is particularly useful if the family do not have legal expenses insurance.

Contact our compassionate and experienced inquests solicitors today

If a family member has died, suddenly and unexpectedly, and you are informed that there is to be an inquest, do not hesitate to contact us. We can provide advice and representation at the inquest, to ensure that there is the fullest possible inquiry into the death of your loved one.

 Contact our legal experts today for a free initial consultation on 0333 123 9099 or email enquiries@ibbclaims.co.uk. Alternatively please complete our online form