Ivana Smit fell from the 20th floor Kuala Lumpur condominium of an American man and landed on a sixth floor balcony in December 2017 after a night out.
The sensational death drew huge amounts of attention after lurid claims emerged that 18-year-old Smit, the American and his Kazakh wife consumed large quantities of drugs and alcohol and had group sex.
Police initially said there was no foul play but authorities agreed to an inquest after pressure from the family of Smit, who had reportedly lived in Malaysia since she was a child.
Handing down her ruling, Coroner Mahyon Talib acknowledged there may have been a struggle between Smit and the couple, businessman Alex Johnson and his wife Luna.
"Grip marks on her arm, the trauma at the back of her head, the broken bottles and (American man) Alex's DNA under Ivana's nails suggest that there might have been a possibility that there was a struggle," she said.
The couple are reported to have left the country.
The coroner also agreed with a Dutch pathologist, who had concluded Smit died before her body was found on the sixth floor balcony.
But she ruled no one was criminally involved in causing the model's death.
"We cannot know what actually happened between the three of them," the coroner said, adding that the death was being classified as "misadventure", meaning it was likely an accident.
Lawyer S. N. Nair, representing Smit's family, criticised the ruling, questioning how the coroner had accepted that Smit was likely killed in the apartment and then concluded the death was "misadventure".
"How is it that her body was eventually found at the bottom of the condominium -- surely a dead body can't walk over and take a dive? Somebody threw her body down," he told reporters at the Kuala Lumpur court.
"I am not satisfied with the verdict."