No, you don't always die when you get hit by a car. It depends on the severity of the accident. If the car is driving fast and hits a pedestrian, there is a chance that the impact will instantly crush the bones and cause massive hemorrhaging. In other words, the impact will break your bones, pop your veins/arteries, cause extensive organ damage and in some cases, cause paralysis if the spinal chord is damaged. Of course, after the initial impact, a pedestrian will fly and be dragged along a road, causing a nasty road abrasion. If a head trauma is involved, then there is a high chance of brain damage and/or death.