Sorin Laszlo has denied causing the death of 22-year-old Blaine Rock, from Dudley, by dangerous driving and causing serious injury to Paul Currie "by reason of insanity".
Despite Laszlo's victims being hit by his Peugeot 308 people-carrier, he carried on driving for another 400 metres before crashing into a lamppost and ending up in a hedge in September 2018, the court was told.
Mr Rock was working alongside his father, Harry, and their workmate, Mr Currie, on a road surfacing crew.
He suffered multiple injuries including a serious neck fracture, while Mr Currie's injuries left him in hospital for three months, during which he was in a coma for the first few weeks.
The two men were working on a section of the B4112 Ansley Road, in Stockingford, Nuneaton, in a coned-off area.
Vehicles passing the roadworks, which prosecutor Mr Matthew Barnes said were "properly and safely cordoned off and delineated by cones", were governed by a three-way set of temporary traffic lights.
Another motorist's dashcam filmed Laszlo, 42, of Grove Road, in Nuneaton, as he ran naked from the scene after the crash and was chased by onlookers who took him to the ground and help him until the police arrived, a jury at Warwick Crown Court heard.
Judge Anthony Potter told the jury that in relation to each charge they had three possible verdicts – guilty, not guilty and not guilty by reason of insanity.
He explained: "It will be suggested that at the time Mr Laszlo was suffering from a disease of the mind, that he was mentally ill and not criminally responsible for his actions.”
The crash happened on September 14, 2018, at around 10.30am.
Mr Barnes, said: "A horrific road traffic collision occurred when a car driven by this defendant struck two wholly innocent and unsuspecting road workers, killing one and seriously injuring the other."
The court heard there were nine or 10 cars waiting at a red light on the 40mph road heading away from the direction of Nuneaton, when Laszlo drove straight past them in the middle of the road at between 30 to 33mph.
Mr Barnes said: "The defendant simply appears to have ignored not only the red light, but the queue of traffic, and simply overtook the queue of stationary vehicles, not braking or reducing his speed.
"The road works were clearly marked, and the workers were wearing high visibility clothing. If it was steered back to its nearside it could have gone through the single-file piece of road adjacent to the road works, but sadly it wasn’t. It simply ploughed ahead, hitting two of the small team of road workers, Blaine Rock and Paul Currie.
"They were both standing drilling the road surface, and they may well have had their backs to the oncoming Peugeot. They were certainly wearing ear protectors because of the noise of the drilling, and it seems likely they were unaware of the danger.
“The Peugeot, having struck the two men, carried them both on its bonnet. Neither of them fell off. They were carried through the road works onto the other side of the road.
“He drove on for about 400 metres, and it was only when he crashed that the two men came off the Peugeot. He failed to negotiate a sharp right-hand bend and lost control and collided at speed with a lamppost.”
The car ended up in a hedge, and Laszlo, whose clothes were later found in the car, got out "completely naked" and ran off – but was chased and caught by "brave and stunned members of the public".
Laszlo, who tested negative for drink or drugs, was arrested and taken to the Tamarind Centre mental health unit in Birmingham, where he has remained, said Mr Barnes.
He pointed out that psychiatrist Dr Dinesh Maganty has found that Laszlo was suffering from paranoid schizophrenia, characterised by delusions of paranoia, believing he was going to be killed by people – including his own brother.
That was an assessment shared by Dr Ramneesh Puri who had examined Laszlo on behalf of the defence, and Mr Barnes told the jury that although the psychiatrists agreed he was legally insane, the verdict was a matter for them.
He added: “Assuming you are satisfied so you are sure that the driving was dangerous, which I venture to suggest you will be, and that the driving caused the death of Mr Rock and the serious injury to Mr Currie, then you have to decide on the balance of probability whether the defence has satisfied you that he was labouring under a defect of reasoning.”
The trial continues.