The coroner concluded that Ms McKay died from "high energy impact injuries to head and brain with pneumonia complicating coma".
The evidence available, including the interpretation of forensic pathologist Dr Martin Sage, is that the injuries are consistent with Ms McKay having exited the ute and hitting the road.
Coroner Crerar said it was "regrettable" that Mr Brown did not attend the inquest, adding that his behaviour was "most unusual and almost unique".
"The vast majority of inquest witnesses attend a hearing to give answers to questions and to give closure to the family of a deceased person," the coroner noted.
"If, as is stated on his behalf, Mike Brown was grieving to the extent that he could not face the inquest hearing, he ought to recognise the legitimate concerns and the grief felt and suffered by the mother and father of Libby McKay and by her other family members."
Although the coroner was able to come to a finding based on the evidence he received, he said there were outstanding questions which could be answered by Mr Brown "if he attended a further inquest hearing".
Coroner Crerar listed eight questions that Mr Brown could answer, including why he did not phone an ambulance immediately, why if he thought it was quicker to take Ms McKay direct to the hospital did he return to their home with her unconscious in the backseat, and how did he place her in the rear seat of the ute.
He also queried how much Ms McKay drank, consumed, and smoked at a West Melton party earlier in the evening.
Witnesses, and statements, variously said she had drank whisky, vodka, and wine, while smoking cannabis and taking magic mushrooms.
The inquest heard from police that Ms McKay had become "very intoxicated" that night and Mr Brown had put her in the back seat of his twin cab ute to drive her home.
At some time during the journey, Ms McKay moved to the front seat.
Mr Brown told police that while driving home, an argument started after Ms McKay expressed a desire to return to the party.
While driving along Halswell Junction Rd, Ms McKay opened the front passenger door of the ute and fell out, he told police, while the vehicle was travelling at between 50km/h to 70km/h.
Police told the inquest that there had been "insufficient evidence" to consider a prosecution against Mr Brown or anyone else.