Trevor's memories finally clear showing him his past sins. He accidentally ran over a child when he took his eyes off the road. His dellusions were his subconcious trying to remind him of these memories.
Factual error: When Trevor is struck by the VW Beetle, not only is he not thrown forward along the Beetle's path, he actually lands well behind the point of impact - more than half the length of the parked van. He doesn't bounce off another object that changes his direction. He's just thrown up, then falls rearward above the car. (01:08:35)johnrosa